NPIMap

Individual provider Active NPI

Kenneth L Bull, MD

  • Family Medicine Physician
  • Pensacola, FL
National Provider Identifier
1356602114
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
61152-20 Issued in WI
Practice address
6000 US-98 Naval Hospital
Pensacola, FL 32512-2111
Phone
(850) 452-8970
NPI assigned
Jun 7, 2012
Last updated
Sep 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 61152-20 WI Primary
General Practice Physician 208D00000X 61152-20 WI

Addresses

Primary practice location

6000 US-98 Naval Hospital
Pensacola, FL 32512-2111

Mailing address

6000 US-98 Naval Hospital
Pensacola, FL 32512-2111
Phone (850) 452-8970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240129000968 FL Practitioner - Family Practice 7012312747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Uniformed Services Uhs Fe Hebert School of Med, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1095 E Nine Mile Rd
Unit 1
Pensacola, FL 32514-7485
Phone (850) 558-4660

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61152-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner 65 Plus Pensacola - University, L.L.C. CurrentSince Dec 19, 2023 Accepting new patients
Ochsner 65 Plus Pensacola - University, L.L.C. CurrentSince Dec 19, 2023 Accepting new patients

Locations

1095 E Nine Mile Rd
Unit 1
Pensacola, FL 32514
Phone (850) 558-4660

1514 Jefferson Hwy
New Orleans, LA 70121

Interoperability endpoints

  • Direct secure messaging: kbull2176018@direct.ochsner.org

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 9

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": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1356602114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 US-98 NAVAL HOSPITAL",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325122111",
            "telephone_number": "850-452-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 US-98 NAVAL HOSPITAL",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325122111",
            "telephone_number": "850-452-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULL",
        "first_name": "KENNETH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-07",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "61152-20",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "61152-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.