Active NPI
Edwin Peter Bullard, BCO, BADO
- Ocularist
- Tulsa, OK
National Provider Identifier
1366076556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ocularist
- Practice address
- 4606 S Garnett Rd Ste 302
Tulsa, OK 74146-5218 - Phone
- (918) 664-6544
- Fax
- (918) 664-0668
- NPI assigned
- Feb 26, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ocularist | 156FX1700X | Primary |
Addresses
Primary practice location
4606 S Garnett Rd Ste 302
Tulsa, OK 74146-5218
Mailing address
4606 S Garnett Rd Ste 302
Tulsa, OK 74146-5218
Phone (918) 664-6544
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Restoration Clinic | Ocularist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582675200000",
"number": "1366076556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4606 S GARNETT RD STE 302",
"city": "TULSA",
"state": "OK",
"postal_code": "741465218",
"telephone_number": "918-664-6544",
"fax_number": "918-664-0668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4606 S GARNETT RD STE 302",
"city": "TULSA",
"state": "OK",
"postal_code": "741465218",
"telephone_number": "918-664-6544",
"fax_number": "918-664-0668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLARD",
"first_name": "EDWIN",
"middle_name": "PETER",
"credential": "BCO, BADO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-26",
"last_updated": "2020-02-26",
"certification_date": "2020-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1700X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ocularist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.