NPIMap

Individual provider Active NPI

Jennifer Renae Bullard, NP-C

  • Family Nurse Practitioner
  • Clinton, TN
National Provider Identifier
1659912731
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
41906 Issued in TN
Practice address
2200 N Charles G Seivers Blvd
Clinton, TN 37716-6738
Phone
(865) 647-3200
Fax
(833) 645-0147
NPI assigned
Sep 30, 2019
Last updated
Sep 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5014203 NC
Family Nurse Practitioner 363LF0000X 57779 ID
Family Nurse Practitioner 363LF0000X 41906 TN Primary

Addresses

Primary practice location

2200 N Charles G Seivers Blvd
Clinton, TN 37716-6738

Mailing address

2200 N Charles G Seivers Blvd
Clinton, TN 37716-6738
Phone (865) 647-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211111001602 NC Practitioner - Nurse Practitioner 4385078740 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Kidney Care PAGroup PAC ID 4587576020, 24 clinicians

Practice addresses (Care Compare)

557 Sandhurst Dr
Fayetteville, NC 28304-4433
Phone (910) 484-8114

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5014203NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Clinic North Carolina PLLC CurrentSince Feb 1, 2022 Accepting new patients
Pinehurst Medical Clinic, Inc. CurrentSince Jul 8, 2024 Accepting new patients
Pinehurst Medical Clinic, Inc. CurrentSince Jul 8, 2024 Accepting new patients
Carolina Kidney Care, PA CurrentSince Jun 9, 2025 Accepting new patients
Bio-Medical Applications of Fayetteville, Inc. Past Accepting new patients
Laurel Hill Medical Clinic PC PastSince Jan 21, 2022 Accepting new patients
Pinehurst Medical Clinic, Inc. Past Accepting new patients

Locations (25 of 26)

219 Martin Luther King Jr Dr
Bladenboro, NC 28320

219 MLK Jr Dr
Bladenboro, NC 28320

1740 Southeast Blvd
Clinton, NC 28328
Phone (910) 592-1600

101 Dialysis Dr
Elizabethtown, NC 28337
Phone (910) 862-7022

704 S Walnut St
Fairmont, NC 28340
Phone (910) 628-6898

130 Longview Dr
Fayetteville, NC 28311
Phone (910) 482-3491

150 Robeson St
Fayetteville, NC 28301
Phone (910) 609-1000

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

2560 Legion Rd
Fayetteville, NC 28306
Phone (910) 323-5288

526 Ramsey St
Fayetteville, NC 28301
Phone (704) 989-1800

557 Sandhurst Dr
Fayetteville, NC 28304

6959 Nexus Ct
Fayetteville, NC 28304
Phone (910) 867-2602

18901 Ida Mill Rd
Laurel Hill, NC 28351
Phone (910) 462-2707

1250 Linkhaw Rd
Lumberton, NC 28358
Phone (910) 348-8760

720 Wesley Pines Rd
Lumberton, NC 28358
Phone (910) 738-2421

810 Wesley Pines Rd
Lumberton, NC 28358
Phone (910) 618-1055

1327 Harry West Ln
Pembroke, NC 28372
Phone (910) 522-7126

15 Regional Dr
Pinehurst, NC 28374
Phone (910) 255-4400

205 Page Rd
Pinehurst, NC 28374
Phone (910) 295-9211

285 Paraclete Dr
Raeford, NC 28376
Phone (910) 878-0052

403 S Main St
Raeford, NC 28376
Phone (910) 875-6561

1000 E 4th Ave
Red Springs, NC 28377
Phone (910) 843-9311

11016 Red Springs Rd
Red Springs, NC 28377
Phone (910) 843-3205

100 E Pleasant St
Roseboro, NC 28382
Phone (910) 525-0405

200 Pavilion Way
Southern Pines, NC 28387
Phone (910) 235-3204

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25499/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jbullard79079@direct.acumenmd.com

Organizations & group practices 7

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1659912731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 N CHARLES G SEIVERS BLVD",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166738",
            "telephone_number": "865-647-3200",
            "fax_number": "833-645-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N CHARLES G SEIVERS BLVD",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166738",
            "telephone_number": "865-647-3200",
            "fax_number": "833-645-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "JENNIFER",
        "middle_name": "RENAE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014203",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "57779",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "41906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, TN

Sources for this page

Verify at the official NPI Registry.