Amicia Bullard, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00783 Issued in OR

Practice address

777 Murphy Rd
Medford, OR 97504-8425

Phone

(541) 772-2763

NPI assigned

Nov 1, 2006

Last updated

May 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5512/brand/1/csg/1/fhir/r4

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.

• CRM Physicians, LLC

  dba Ascent Healthcare

  • Internal Medicine Physician
  • Beaverton, OR
  • NPI 1952674996
  Medicare reassignment
• Onepeak Southern Oregon PC

  • Family Medicine Physician
  • Medford, OR
  • NPI 1740917558
  Medicare reassignment
• Pain Care of Oregon, LLC

  dba Pain Specialists of Southern Oregon

  • Interventional Pain Medicine Physician
  • Medford, OR
  • NPI 1699793505
  Medicare reassignment
• Providence Health & Services Oregon

  dba Providence Specialty Pharmacy Services-Infusion/SPP

  • Home Infusion Therapy Pharmacy
  • Portland, OR
  • NPI 1427132265
  NPD (past)
• Olympia Orthopaedic Associates PLLC

  dba Centralia Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Olympia, WA
  • NPI 1083785398
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1568549723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13765 CAMEO CT",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970342128",
            "telephone_number": "503-317-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 MURPHY RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048425",
            "telephone_number": "541-772-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "AMICIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00783",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA00783",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Donald Buhler, DC
• Thong Tien Bui, MD
• Xem Ma Bui, MD
• Amanda M Bujaucius, CNM
• Pedro Bujosa, MD
• Katherine Ann Buono, LMT
• Peter Burch
• Travis Scott Burch
• Brooke Anne Burdett
• Jennifer Burditt, RDH

• Physician Assistant in Medford, OR
• Providers in Medford, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.

Verify at the official NPI Registry.