Misty Star Bullock

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC009582 Issued in PA

Practice address

2032 S Frazier St
Philadelphia, PA 19143-5618

Phone

(267) 736-9099

NPI assigned

Jan 1, 2008

Last updated

Jan 1, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Better Living Rehabilitation

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1205146750
  Authorized official Same address or phone
• Bright Life Therapy Inc.

  • Home Health Agency
  • Philadelphia, PA
  • NPI 1972744928
  NPD (past) Authorized official
• Orthopaedic and Neurological Rehab Inc

  • Rehabilitation Clinic/Center
  • Billings, MT
  • NPI 1225496540
  NPD
• Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc

  • Rehabilitation Clinic/Center
  • Tustin, CA
  • NPI 1548940885
  NPD
• Unh Physical Therapy Corp

  dba UNH Therapy Services

  • Physical Therapist
  • Rocklin, CA
  • NPI 1902530785

  Occupational Therapist

  NPD
• House Call Group, PC

  • Family Medicine Physician
  • Flourtown, PA
  • NPI 1235136904
  NPD (past)
• House Call Medical Services, P.C.

  • Family Medicine Physician
  • Flourtown, PA
  • NPI 1720533854
  NPD (past)
• Functional Pathways of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1922218122

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1199145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199145600000",
    "number": "1639354335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2032 S FRAZIER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191435618",
            "telephone_number": "267-736-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2032 S FRAZIER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191435618",
            "telephone_number": "267-736-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "MISTY",
        "middle_name": "STAR",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-01",
        "last_updated": "2008-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC009582",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT11929",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Sowden Bullock, LCSW
• India Michelle Bullock
• Jennifer Bullock, M.ED., M.L.S.P.
• Justin Bullock
• Meghan Borie Bullock, MD
• Oliver C. Bullock, DO
• Sheldon Bullock
• Walter J Bullock, MS
• Stephen Ian Bulova, M.D.
• Mark Bulson

• Occupational Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2008; 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.