Carmen N. Bullock, O. D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002990 Issued in IN

Practice address

2373 E Main St
Wal-Mart Vision Center
Plainfield, IN 46168-2717

Phone

(317) 839-0713

Fax

(317) 837-4093

NPI assigned

May 8, 2006

Last updated

Dec 16, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mooresville Family Eyecare, PCGroup PAC ID 9830210319, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bullock Optometry PC

  • Optometrist
  • Plainfield, IN
  • NPI 1043478027
  Medicare reassignment NPD Authorized official
• Mooresville Family Eyecare, PC

  • Eyewear Supplier
  • Mooresville, IN
  • NPI 1396905204
  Medicare reassignment Care Compare group NPD
• Dr Linda a Frechette Inc.

  • Optometrist
  • Franklin, IN
  • NPI 1578745733
  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1437108685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 KINGSVIEW DR",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461582734",
            "telephone_number": "317-839-0713",
            "fax_number": "317-837-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 E MAIN ST",
            "address_2": "WAL-MART VISION CENTER",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461682717",
            "telephone_number": "317-839-0713",
            "fax_number": "317-837-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "CARMEN",
        "middle_name": "N.",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200240510",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Brown, RBT
• Virginia Dawn Brown, LPN
• Kelsea Broyles, NP
• Alexis Brumfield, APN
• Bullock Optometry PC
• Makayla Burba, RBT
• Samantha Burk, RBT
• Marisa Lynn Burkhart
• Tommy Burns
• Robert Buroff

• Optometrist in Plainfield, IN
• Providers in Plainfield, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; 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.
• 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.