Individual provider Active NPI

Lorraine Bullock, NP

  • Family Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1316183023
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024168125 Issued in VA
Practice address
300 Park Hill Dr
Fredericksburg, VA 22401-3387
Phone
(540) 361-7641
Fax
(540) 361-1246
NPI assigned
Dec 30, 2008
Last updated
Oct 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024168125 VA Primary

Addresses

Primary practice location

300 Park Hill Dr
Fredericksburg, VA 22401-3387

Mailing address

PO Box 1460
Fredericksburg, VA 22402-1460
Phone (540) 785-2100

Other identifiers 2

IdentifierTypeStateIssuer
1316183023MedicaidVA
1316183023OtherVAVA PREMIER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090120000645 VA Practitioner - Nurse Practitioner 4789747650 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Health Care Providers, Inc.Group PAC ID 4789962408, 4 clinicians

Practice addresses (Care Compare)

300 Park Hill Dr
Fredericksburg, VA 22401-3387
Phone (540) 368-7316

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024168125VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Urgent Care LLC CurrentSince Mar 24, 2014 Accepting new patients
Metropolitan Health Care Providers, Inc. CurrentSince Jun 1, 2016 Accepting new patients

Locations

300 Park Hill Dr
Fredericksburg, VA 22401
Phone (540) 361-7641

12581 Milstead Way
Ste 103
Woodbridge, VA 22192
Phone (703) 897-5890

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1316183023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224021460",
            "telephone_number": "540-785-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PARK HILL DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013387",
            "telephone_number": "540-361-7641",
            "fax_number": "540-361-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "LORRAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-30",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024168125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316183023",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA PREMIER",
            "identifier": "1316183023",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.