Individual provider Active NPI

Abigail Jessie Bullard

  • Student in an Organized Health Care Education/Training Program
  • Charlton, MA
National Provider Identifier
1316850803
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
PI168649 Issued in MA
Practice address
17 Glen Echo Shore Rd
Charlton, MA 01507-5422
Phone
(508) 688-9544
NPI assigned
Sep 24, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PI168649 MA Primary

Addresses

Primary practice location

17 Glen Echo Shore Rd
Charlton, MA 01507-5422

Mailing address

17 Glen Echo Shore Rd
Charlton, MA 01507-5422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1316850803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 GLEN ECHO SHORE RD",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015075422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 GLEN ECHO SHORE RD",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015075422",
            "telephone_number": "508-688-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "ABIGAIL",
        "middle_name": "JESSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "PI168649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.