Active NPI
Nicholas Freeman Bullock
- Family Nurse Practitioner
- Pocatello, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN002631
- Practice address
- 777 Hospital Way
Pocatello, ID 83201-5175 - Phone
- (208) 239-1000
- NPI assigned
- Aug 15, 2013
- Last updated
- Oct 1, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Health Nurse Practitioner | 363LX0106X | NP-1308A | ID | |
| Family Nurse Practitioner | 363LF0000X | APRN002631 | NV | Primary |
| Nurse Practitioner | 363L00000X | APRN002631 | NV | |
| Family Nurse Practitioner | 363LF0000X | NP-1308A | ID |
Addresses
Primary practice location
777 Hospital Way
Pocatello, ID 83201-5175
Mailing address
777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 239-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP-1308A | ID | MD | Family Nurse Practitioner |
| APRN002631 | NV | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Current Care PA | Current | Accepting new patients | |
| American Current Care P.a. | Current | Accepting new patients | |
| American Current Care PA | Current | Accepting new patients |
Locations
149 N Gibson Rd
Ste H
Henderson, NV 89014
Phone (702) 558-6275
5850 Polaris Ave
Ste 100
Las Vegas, NV 89118
Phone (702) 739-9957
255 Glendale Ave
Ste 12
Sparks, NV 89431
Phone (775) 356-8181
5080 Spectrum Dr
Ste 1200W
Addison, TX 75001
Organizations & group practices 3
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.
-
dba Concentra Urgent Care
- Urgent Care Clinic/Center
- Addison, TX
- NPI 1275714677
NV
-
dba Concentra Urgent Care
- Urgent Care Clinic/Center
- Beaumont, TX
- NPI 1376356568
-
dba Concentra Urgent Care
- Urgent Care Clinic/Center
- Reno, NV
- NPI 1487996054
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790812800000",
"number": "1508299348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 HOSPITAL WAY",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832015175",
"telephone_number": "208-239-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 HOSPITAL WAY",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832015175",
"telephone_number": "208-239-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLOCK",
"first_name": "NICHOLAS",
"middle_name": "FREEMAN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-15",
"last_updated": "2026-10-01",
"certification_date": "2026-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0106X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Occupational Health",
"state": "ID",
"license": "NP-1308A",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NV",
"license": "APRN002631",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NV",
"license": "APRN002631",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "NP-1308A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.