Honorio R Bulos, M.D.,F.A.A.P.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

48029 Issued in GA

Practice address

300 Dawson Commons Cir
Ste 320
Dawsonville, GA 30534-6268

Phone

(706) 216-2770

Fax

(706) 216-2944

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

Yes

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.

• Dawson Pediatrics,PC

  • Pediatrics Physician
  • Dawsonville, GA
  • NPI 1750435749
  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: honorio.bulos@gadirect.net

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

Specialties & licenses 1

Addresses

Other identifiers 8

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367971200000",
    "number": "1497712939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 DAWSON COMMONS CIR",
            "address_2": "STE 320",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346268",
            "telephone_number": "706-216-2770",
            "fax_number": "706-216-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 DAWSON COMMONS CIR",
            "address_2": "STE 320",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346268",
            "telephone_number": "706-216-2770",
            "fax_number": "706-216-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULOS",
        "first_name": "HONORIO",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.,F.A.A.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2013-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "GA",
            "license": "48029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000862584B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE TLC",
            "identifier": "341290",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GA",
            "identifier": "52837775",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACHSTATE",
            "identifier": "000862584B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000862584C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10032539",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "328286",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP TLC",
            "identifier": "10049707",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Benjamin Bridges, PHARMD
• Rachel Baker Bright, FNP
• Brittany Lynn Brooks, PHARMD
• Keyle Clemons Brown
• Amy Cagle Bruce, PHARMD
• Brittany Michele Bumgarner, H.I.S.
• Brian P Burke, O.D.
• Kimberly Sue Burns, NP-C
• R Ashley Burrow, CSA
• Dawn Marie Burt, AGNP

• All providers in Dawsonville, GA
• Pediatric Adolescent Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; 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.