Individual provider Active NPI

Philip Corey Bulls

  • Massage Therapist
  • Clayton, NC
National Provider Identifier
1487330817
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
20746 Issued in NC
Practice address
260 Colson Ridge Dr
Clayton, NC 27520-8748
Phone
(706) 442-9022
NPI assigned
Jun 21, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 282801 KY
Massage Therapist 225700000X 20746 NC Primary

Addresses

Primary practice location

260 Colson Ridge Dr
Clayton, NC 27520-8748

Mailing address

260 Colson Ridge Dr
Clayton, NC 27520-8748
Phone (706) 442-9022

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
282801KYMDMassage Therapist
20746NCMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1487330817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 COLSON RIDGE DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275208748",
            "telephone_number": "706-442-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 COLSON RIDGE DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275208748",
            "telephone_number": "706-442-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLS",
        "first_name": "PHILIP",
        "middle_name": "COREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "282801",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NC",
            "license": "20746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.