Melonie Bullock-Sanders, N/A

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

012794099 Issued in LA

Practice address

1915 Highland Ave
Shreveport, LA 71101-4818

Phone

(940) 577-8536

Fax

(972) 753-6400

NPI assigned

Sep 21, 2007

Last updated

Feb 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708732800000",
    "number": "1255527412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 HIGHLAND AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014818",
            "telephone_number": "940-577-8536",
            "fax_number": "972-753-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 HIGHLAND AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014818",
            "telephone_number": "940-577-8536",
            "fax_number": "972-753-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK-SANDERS",
        "first_name": "MELONIE",
        "name_prefix": "Ms.",
        "credential": "N/A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2024-02-24",
        "certification_date": "2024-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": "012794099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary A Buffington, M.D.
• Tonya Jerece Buggs
• Roger Bui, MD
• Ryan Majid Bukhari, DDS
• Tanisha Bullard
• Elaine S Bullock
• Benjamin Joseph Bumgardner, D.D.S.
• Bundrick and O'Neal Plastic Surgery (AMC)
• Anna Kaitlyn Bundrick, BCBA
• Claude Youngblood Bundrick Jr., MD

• Case Manager/Care Coordinator in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.