NPIMap

Organization Active NPI

Bull City Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • Durham, NC
National Provider Identifier
1235749060
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
BULL CITY PHYSICAL THERAPY
Practice address
1019 Broad St
Durham, NC 27705-4143
Phone
(919) 797-9588
Fax
(949) 655-8592
NPI assigned
Aug 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Colten Sullivan, DPTNPI 1306303458
Title
Owner/PT
Phone
(509) 205-4973

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1019 Broad St
Durham, NC 27705-4143

Mailing address

1019 Broad St
Durham, NC 27705-4143
Phone (919) 797-9588

Other practice location 1

1105 Copeland Oaks Dr
Morrisville, NC 27560-6611
Phone (919) 797-9588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201021002655 NC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8022438563 Receives reassigned benefits from 10 practitioners
Practice locations: Charlotte, NC; Durham, NC

National Provider Directory

National Provider Directory

Locations

412 W Palmer St
Charlotte, NC 28203
Phone (980) 987-7885

1300 S Mint St
Ste 405
Charlotte, NC 28203
Phone (980) 987-7885

1019 Broad St
Durham, NC 27705
Phone (919) 286-0009

2402 S Miami Blvd
Ste 106
Durham, NC 27703
Phone (919) 797-9588

719 Broad St
Durham, NC 27705
Phone (919) 280-6394

1105 Copeland Oaks Dr
Morrisville, NC 27560
Phone (919) 614-1923

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1235749060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054143",
            "telephone_number": "919-797-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054143",
            "telephone_number": "919-797-9588",
            "fax_number": "949-655-8592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 Copeland Oaks Dr",
            "address_purpose": "LOCATION",
            "city": "Morrisville",
            "state": "NC",
            "postal_code": "275606611",
            "country_code": "US",
            "telephone_number": "919-797-9588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BULL CITY PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "COLTEN",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "509-205-4973",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.