Individual provider Active NPI

Todd R Bullinger, D.C.

  • Chiropractor
  • Elida, OH
National Provider Identifier
1356445084
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3680 Issued in OH
Practice address
415 E Kiracofe Ave
Elida, OH 45807-1031
Phone
(419) 227-2639
Fax
(419) 227-2640
NPI assigned
Sep 12, 2006
Last updated
Jul 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3680 OH Primary
Chiropractor 111N00000X 08002237A IN

Addresses

Primary practice location

415 E Kiracofe Ave
Elida, OH 45807-1031

Mailing address

415 E Kiracofe Ave
Elida, OH 45807-1031
Phone (419) 227-2639

Other identifiers 4

IdentifierTypeStateIssuer
9363471OtherOHPTAN
200811670MedicaidIN
9312811OtherOHPTAN
2624897MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060123000477 OH Practitioner - Chiropractic 5496779092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

415 E Kiracofe Ave
Elida, OH 45807-1031
Phone (419) 227-2639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002237AINMDChiropractor
3680OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Back to Health, LLC Chiropractor Past Accepting new patients
Bultemeyer Chiropractic, LLC Chiropractor PastSince Jan 9, 2015 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1356445084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E KIRACOFE AVE",
            "city": "ELIDA",
            "state": "OH",
            "postal_code": "458071031",
            "telephone_number": "419-227-2639",
            "fax_number": "419-227-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E KIRACOFE AVE",
            "city": "ELIDA",
            "state": "OH",
            "postal_code": "458071031",
            "telephone_number": "419-227-2639",
            "fax_number": "419-227-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLINGER",
        "first_name": "TODD",
        "middle_name": "R",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3680",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002237A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "9363471",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200811670",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "9312811",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2624897",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elida, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.