Individual provider Active NPI

Kiera Bulluck

  • Student in an Organized Health Care Education/Training Program
  • Aurora, CO
National Provider Identifier
1467192906
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
12700 E 19TH Ave # 9Co3
Aurora, CO 80045-2560
Phone
(303) 724-9287
NPI assigned
Mar 31, 2022
Last updated
Jul 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

12700 E 19TH Ave # 9Co3
Aurora, CO 80045-2560

Mailing address

12700 E 19TH Ave # 9Co3
Aurora, CO 80045-2560
Phone (303) 724-9287

Other practice location 1

500 Parnassus Ave
San Francisco, CA 94143-2203
Phone (415) 476-4562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250625002045 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4486166493

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1467192906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 E 19TH AVE # 9CO3",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452560",
            "telephone_number": "303-724-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 E 19TH AVE # 9CO3",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452560",
            "telephone_number": "303-724-9287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Parnassus Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432203",
            "country_code": "US",
            "telephone_number": "415-476-4562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLUCK",
        "first_name": "KIERA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2025-07-01",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.