Traci A Bullock, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

I28281 Issued in AL

Practice address

101 Fitness Way Ste 1200
Athens, AL 35611-2492

Phone

(256) 236-0636

Fax

(256) 232-1281

NPI assigned

Jan 8, 2020

Last updated

Jan 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Obstetrics and Womens Pelvic Health CenterGroup PAC ID 3476726480, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Athens Limestone Hospital Hospital, Athens, AL, CCN 010079

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valley Obstetrics & Womens Pelvic Health Center

  • Obstetrics & Gynecology Physician
  • Athens, AL
  • NPI 1487938494
  Medicare reassignment Care Compare group NPD
• Belinda Maples M.D., P.C.

  • Family Medicine Physician
  • Athens, AL
  • NPI 1346318474
  Medicare reassignment NPD
• Elkmont Community Care

  • Family Medicine Physician
  • Elkmont, AL
  • NPI 1194207084
  Medicare reassignment NPD
• Tanner Community Care

  • Family Medicine Physician
  • Tanner, AL
  • NPI 1134791668
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HH Health System - Athens Limestone, LLC

  dba Athens Limestone Hospital

  • General Acute Care Hospital
  • Athens, AL
  • NPI 1144695081
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1124668132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 FITNESS WAY STE 1200",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112492",
            "telephone_number": "256-236-0636",
            "fax_number": "256-232-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 FITNESS WAY STE 1200",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112492",
            "telephone_number": "256-236-0636",
            "fax_number": "256-232-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "TRACI",
        "middle_name": "A",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "I28281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "I128481",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica McKleroy Brown, MA, LPC
• Marcus Brown Jr., THERAPIST
• Patrick Allen Brunson, RPH
• Alyssa Bryant
• Devin Buchheister, DPT
• Felicia M Butler, MSW
• Matthew Bragg Caldwell, MD
• Caleb Hodges, DMD, LLC (Hodges Family Dental)
• Jessie Calliste
• Riley William Camp, OD

• Family Nurse Practitioner in Athens, AL
• Providers in Athens, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.