Jerry Morgan Bullard, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN0000034015 Issued in TN

Practice address

1114 Sunset Dr
Suite 4
Johnson City, TN 37604-2969

Phone

(423) 283-0776

Fax

(423) 283-0549

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1598765919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3727",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376023727",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 SUNSET DR",
            "address_2": "SUITE 4",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042969",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "JERRY",
        "middle_name": "MORGAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN0000034015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3600367",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Buckley, D.O.
• Morgan Buda, MD
• Robert Cason Buehler
• Nicole Buhr
• Sabrina Bulancea, MD
• Michelle S Bullman, MD
• Yvette M Bullock, MSW
• Haley Bullough, RPH
• David J Bumgarner, PHD
• Alan C Bunger, PT

• Certified Registered Nurse Anesthetist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.