Carolyn R Bullock, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34002995 Issued in OH

Practice address

7630 Rivers Edge Dr
Columbus, OH 43235-1337

Phone

(614) 533-4000

Fax

(614) 540-3979

NPI assigned

Jan 17, 2006

Last updated

Jun 19, 2019By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Ohiohealth Corporation

  dba OhioHealth Physician Group, Inc

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1578545273
  Medicare reassignment NPD
• Ohiohealth Corporation

  dba OhioHealth Physician Group Inc

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1407292105
  NPD
• Immediate Health Associates

  • Emergency Medicine Physician
  • Westerville, OH
  • NPI 1639123193
  NPD (past)
• The Millhon Clinic, Inc

  dba Millhon Clinic

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1023013133

  Family Medicine

  NPD (past)
• Wedgewood Urgent Care, LTD

  • Family Medicine Physician
  • Powell, OH
  • NPI 1487601167
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1659350775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7630 RIVERS EDGE DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432351337",
            "telephone_number": "614-533-4000",
            "fax_number": "614-540-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "CAROLYN",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34002995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0427514",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Leigh Bull
• Keri Bull
• Lauren Bull, PHARMD, RPH
• Lakianashauntavia Ashinae Bullard
• Megan E Buller, MD
• Jennifer Zane Bullock, MD
• Joseph D. Bullock, MD
• Thomas R. Bullock, M.D.
• Kristy Lynn Bultema, D.D.S.
• Meridith Bumb, RN

• Family Medicine Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.