Individual provider Active NPI

Brooklyn Danielle Tucker Bulls, OT

  • Occupational Therapist
  • Rogersville, AL
National Provider Identifier
1558933481
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5012 Issued in AL
Practice address
6618 Highway 101
Rogersville, AL 35652-1926
Phone
(256) 810-8895
NPI assigned
Jul 12, 2021
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5012 AL Primary

Addresses

Primary practice location

6618 Highway 101
Rogersville, AL 35652-1926

Mailing address

1931 Central Pkwy SW
Decatur, AL 35601-6848
Phone (256) 309-0454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211022000742 AL Practitioner - Occupational Therapist in Private Practice 5496143521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encore Rehabilitation, IncGroup PAC ID 3577462126, 182 clinicians

Practice addresses (Care Compare)

615 Mynatt St SW
Suite a
Hartselle, AL 35640-2878
Phone (256) 773-0138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5012ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc CurrentSince Jan 8, 2024 Accepting new patients
Encore Rehabilitation, Inc. Occupational Therapist CurrentSince Jan 8, 2024 Accepting new patients
Therapy Achievements, LLC Occupational Therapist CurrentSince Jul 17, 2021 Accepting new patients

Locations

22423 US Highway 72
Ste C
Athens, AL 35613
Phone (256) 232-1221

251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708

42465 Highway 195
Haleyville, AL 35565
Phone (205) 486-2753

615 Mynatt St SW
Ste A
Hartselle, AL 35640
Phone (256) 773-0138

3601 Cci Dr NW
Ste 270
Huntsville, AL 35805
Phone (256) 509-4398

802 Shoney Dr SW
Ste C
Huntsville, AL 35801
Phone (256) 509-4398

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.

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1558933481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 CENTRAL PKWY SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016848",
            "telephone_number": "256-309-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6618 HIGHWAY 101",
            "city": "ROGERSVILLE",
            "state": "AL",
            "postal_code": "356521926",
            "telephone_number": "256-810-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLS",
        "first_name": "BROOKLYN",
        "middle_name": "DANIELLE TUCKER",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "5012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogersville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.