James D Bullard, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

101805 Issued in MO

Practice address

2950 NE Jellison Rd
Blue Springs, MO 64014-0900

Phone

(816) 507-3260

NPI assigned

Nov 15, 2006

Last updated

Oct 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

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.

• Boost Sports Performance, LLC

  dba Boost Physical Therapy & Sports Performance

  • Physical Therapy Clinic/Center
  • Lee's Summit, MO
  • NPI 1548428931
  Medicare reassignment NPD

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1134291107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 NE JELLISON RD",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640140900",
            "telephone_number": "816-507-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 NE JELLISON RD",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640140900",
            "telephone_number": "816-507-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "JAMES",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "101805",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MO",
            "license": "101805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IN",
            "identifier": "22381016",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "486710726",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan Watanabe DDS, White Oaks Dental Group, PC
• Emily Ann Bryan, MD
• Megan Marie Buckley
• Christine Elizabeth Buechler, MSN, FNP
• Christopher Buhr, PTA
• Burrow Family Chiropractic LLC
• Angela K Burton, MS, CCC/SLP
• Griffith Cady, DPT
• Ricke Dale Callicoat
• Angela Kay Callicott, PT

• Pediatric Physical Therapist in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• Pediatric Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.