Active NPI
Jacob Andrew Bullock, D.C.
- Chiropractor
- Lexington, KY
National Provider Identifier
1154476653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4918
- Practice address
- 152 W Zandale Dr
Suite 101
Lexington, KY 40503-2486 - Phone
- (859) 272-0099
- Fax
- (859) 272-0073
- NPI assigned
- Jan 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4918 | KY | Primary |
Addresses
Primary practice location
152 W Zandale Dr
Suite 101
Lexington, KY 40503-2486
Mailing address
152 W Zandale Dr
Suite 101
Lexington, KY 40503-2486
Phone (859) 272-0099
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85003333 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367798400000",
"number": "1154476653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 W ZANDALE DR",
"address_2": "SUITE 101",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405032486",
"telephone_number": "859-272-0099",
"fax_number": "859-272-0073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 W ZANDALE DR",
"address_2": "SUITE 101",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405032486",
"telephone_number": "859-272-0099",
"fax_number": "859-272-0073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLOCK",
"first_name": "JACOB",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-24",
"last_updated": "2013-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KY",
"license": "4918",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "85003333",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.