Individual provider Active NPI

James D Bullen, M.D.

  • Diagnostic Radiology Physician
  • Stillwater, OK
National Provider Identifier
1366424160
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
13741 Issued in OK
Practice address
816 S Walnut St
Stillwater, OK 74074-4225
Phone
(405) 743-0550
Fax
(405) 743-1704
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 13741 OK Primary

Addresses

Primary practice location

816 S Walnut St
Stillwater, OK 74074-4225

Mailing address

816 S Walnut St
Stillwater, OK 74074-4225
Phone (405) 743-0550

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13741OKMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Radiology LLC Diagnostic Radiology PastSince Oct 1, 2005 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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1366424160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 S WALNUT ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744225",
            "telephone_number": "405-743-0550",
            "fax_number": "405-743-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 S WALNUT ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744225",
            "telephone_number": "405-743-0550",
            "fax_number": "405-743-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLEN",
        "first_name": "JAMES",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "13741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.