Individual provider Active NPI

Karla Bullock, LCSW

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1457162927
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11523-123 Issued in WI
Practice address
1015 Gammon LN
Madison, WI 53719-2210
Phone
(608) 417-8132
NPI assigned
Jan 15, 2025
Last updated
Jan 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Clinical Social Worker 1041C0700X WI
Clinical Social Worker 1041C0700X 11523123 WI
Clinical Social Worker 1041C0700X 11523-123 WI Primary

Addresses

Primary practice location

1015 Gammon LN
Madison, WI 53719-2210

Mailing address

1015 Gammon LN
Madison, WI 53719-2210
Phone (608) 417-8132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260414000202 WI Practitioner - Clinical Social Worker 3274008628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1015 Gammon LN
Madison, WI 53719-2210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11523-123WIMDClinical Social Worker
11523123WIMDClinical Social Worker

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

NPI Registry JSON

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1457162927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 GAMMON LN",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537192210",
            "telephone_number": "608-417-8132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 GAMMON LN",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537192210",
            "telephone_number": "608-417-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "KARLA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11523123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11523-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.