Grant A Bullock

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO3385 Issued in NV

Practice address

4029 Dean Martin Dr
Las Vegas, NV 89103-4138

Phone

(702) 848-2256

NPI assigned

Apr 14, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV, AZ, WA, IL, KY, OK, MS, SD, MI, TN, VT, DC, WY, AL, MT, KS, TX17 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 17

Specialty

Psychiatry

Education

Univ of Nevada, Las Vegas School of Dental Med, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Anywhere Clinic LLCGroup PAC ID 4183996317, 32 clinicians

Bauza Neuropsychiatry Center LLCGroup PAC ID 7618370040, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Anywhere Clinic LLC

  dba Calm Clinic

  • Psychiatry Physician
  • Las Vegas, NV
  • NPI 1316460850

  AL, AZ, DC, IL, KS, KY, MI, MS, MT, OK, SD, TN, TX, VT, WA, WY

  Medicare reassignment Care Compare group NPD
• Bauza Neuropsychiatry Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Las Vegas, NV
  • NPI 1912596685
  Medicare reassignment Care Compare group NPD
• New Jersey Anywhere Clinic LLC

  • Psychiatry Physician
  • Brick, NJ
  • NPI 1114874336
  NPD (past) Authorized official
• Success TMS of Nevada PLLC

  • Psychiatry Physician
  • Henderson, NV
  • NPI 1104597202
  NPD
• Dodge Therapy LLC

  dba Fyzical Therapy and Balance Centers

  • Physical Therapist
  • Lockport, IL
  • NPI 1083297196
  NPD
• Bral International Medical Institute

  • Psychiatry Physician
  • Las Vegas, NV
  • NPI 1205556081

  Family Medicine

  NPD (past)
• Bral International Medical Institute LLC

  • Psychiatry Physician
  • Las Vegas, NV
  • NPI 1619604279
  NPD (past)
• Unlv Medicine

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1407397235
  NPD (past)
• Anywhere Clinic PC

  • Psychiatry Physician
  • Mill Valley, CA
  • NPI 1235974700
  NPD (past)

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1174086391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3014 W CHARLESTON BLVD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891020083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 DEAN MARTIN DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891034138",
            "telephone_number": "702-848-2256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3014 W Charleston Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891020083",
            "country_code": "US",
            "telephone_number": "702-671-5127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 E Madison St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981124865",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 Nasa Pkwy Ste 225",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770583362",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "185 Tilley Dr Ste 55",
            "address_purpose": "LOCATION",
            "city": "South Burlington",
            "state": "VT",
            "postal_code": "054034484",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 E Madison St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981124865",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 Magnolia Ct Ste 205",
            "address_purpose": "LOCATION",
            "city": "Moore",
            "state": "OK",
            "postal_code": "731601391",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2158 Judicial Dr",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383823",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "416 S Dakota St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "SD",
            "postal_code": "574014615",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6952 Dogwood Mnr N Ste 104",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386542091",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Office Park Cir Ste 317",
            "address_purpose": "LOCATION",
            "city": "Mountain Brk",
            "state": "AL",
            "postal_code": "352232511",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4578 N 1st Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857185748",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 Connecticut Ave NW Ste 203",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200361762",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16109 S Farrell Rd",
            "address_purpose": "LOCATION",
            "city": "Lockport",
            "state": "IL",
            "postal_code": "604418200",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2333 Alexandria Dr # 112",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405043215",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2535 E Mount Hope Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489101913",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7115 Kentwell Ln",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685166693",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44 Princeton Ave Ste E",
            "address_purpose": "LOCATION",
            "city": "Brick",
            "state": "NJ",
            "postal_code": "087243550",
            "country_code": "US",
            "telephone_number": "702-848-2256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "GRANT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "DO3385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rheyvie Mahal P Bullecer, RN
• Aaron B Bulleigh, D.D.S.
• Ann Blyth Bullis, LCSW
• Chad Bullock, FNP-C
• Devon Angelique Bullock
• Jahiem Bullock
• John Bullock
• Ruhiyyih Bullock
• Sharon Bullock
• Steven D'Lando Bullock

• Psychiatry Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatry Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.