Active NPI
Jill M Bullard, NP
- Family Nurse Practitioner
- Tifton, GA
National Provider Identifier
1649669003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN174048
- Practice address
- 2225 US Highway 41 N
Tifton, GA 31794-2749 - Phone
- (229) 391-4100
- NPI assigned
- Jan 22, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN174048 | GA | Primary |
Addresses
Primary practice location
2225 US Highway 41 N
Tifton, GA 31794-2749
Mailing address
1948 Old Ocilla Rd
Tifton, GA 31794-1644
Phone (229) 391-3500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150415000593 | GA | Practitioner - Nurse Practitioner | 7810215290 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tift Regional Health System Inc | Current | Accepting new patients | |
| South Georgia Emergency Medicine Associates PC | Current | Accepting new patients | |
| United Obstetrics and Gynecology, P.C. | Past | Accepting new patients | |
| Womens Center for Advanced Surgery Inc | Past | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575
907 18th St E
Ste 150
Tifton, GA 31794
Phone (229) 353-3422
2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Thomasville, GA
- NPI 1386903649
GA
-
- Internal Medicine Physician
- Tifton, GA
- NPI 1326271669
-
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
-
- Obstetrics & Gynecology Physician
- Tifton, GA
- NPI 1205847639
-
- Ambulatory Surgical Clinic/Center
- Tifton, GA
- NPI 1295086049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765324800000",
"number": "1649669003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1948 OLD OCILLA RD",
"city": "TIFTON",
"state": "GA",
"postal_code": "317941644",
"telephone_number": "229-391-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 US HIGHWAY 41 N",
"city": "TIFTON",
"state": "GA",
"postal_code": "317942749",
"telephone_number": "229-391-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLARD",
"first_name": "JILL",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-22",
"last_updated": "2025-12-10",
"certification_date": "2025-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN174048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tifton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.