Ty A. Bullington, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN-NP242862 Issued in GA

Practice address

3650 Steve Reynolds Blvd
Duluth, GA 30096-4506

Phone

(404) 365-0966

NPI assigned

Jun 9, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment NPD
• Beacon Health Alliance PC

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1447205182
  NPD (past)

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1407015951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 PEACHTREE WALK NE UNIT B211",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093949",
            "telephone_number": "615-293-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 STEVE REYNOLDS BLVD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964506",
            "telephone_number": "404-365-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLINGTON",
        "first_name": "TY",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "APRN-NP242862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin David Buell
• Caroline Elizabeth Lozen Bufalini, LCSW
• Ruslana Bugera
• Amanda Bui
• Tommy Bui
• Asaf Bullkich, OD
• Daniela Burciu
• Khemiah Burke
• Shelton Keith Burlison, DMD
• William Elton Burnett, D.O

• Pediatric Nurse Practitioner in Duluth, GA
• Providers in Duluth, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.