Individual provider Active NPI

Jessica Lynn Bullard, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cary, NC
National Provider Identifier
1164178265
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5015854 Issued in NC
Practice address
115 Kildaire Park Dr Ste 402
Cary, NC 27518-8144
Phone
(919) 899-7566
NPI assigned
Feb 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5015854 NC Primary

Addresses

Primary practice location

115 Kildaire Park Dr Ste 402
Cary, NC 27518-8144

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20240411000786 NC Practitioner - Nurse Practitioner 1456799337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swift Creek Mental Health ServicesGroup PAC ID 7214355072, 3 clinicians

Practice addresses (Care Compare)

1100 NW Maynard Rd
Suite 140
Cary, NC 27513-8707
Phone (919) 424-0062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5015854NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swift Creek Mental Health Services Psychiatric/Mental Health CurrentSince Feb 27, 2024 Accepting new patients
Mindpath Care Centers, North Carolina, PLLC Psychiatric/Mental Health CurrentSince Nov 1, 2025 Accepting new patients

Locations

3835 N Freeway Blvd
Ste 100
Sacramento, CA 95834
Phone (916) 576-7898

4 Doctors Park
Ste H
Asheville, NC 28801
Phone (828) 633-6070

115 Kildaire Park Dr
Ste 402
Cary, NC 27518
Phone (919) 443-4100

523 Keisler Dr
Ste 202
Cary, NC 27518
Phone (919) 424-0062

1100 NW Maynard Rd
Ste 140
Cary, NC 27513
Phone (919) 428-2766

10027 US 70 Hwy W
Clayton, NC 27520
Phone (919) 424-0062

Interoperability endpoints

  • Direct secure messaging: jessicabullard.swiftcreekmentalhealthservices@160237.advancedmd-direct.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1164178265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 KILDAIRE PARK DR STE 402",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275188144",
            "telephone_number": "919-899-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5015854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.