Ashley Bullock, MD
Individual provider Active NPI Emergency Medicine Physician · Leavenworth, KS
NPI 1669850046 · NPPES record last updated Sep 26, 2019
Key facts
- NPI
- 1669850046
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 0440918 (KS)
- Practice address
- 711 Marshall St
Leavenworth, KS 66048-3235 - Phone
- (913) 684-1144
- NPI assigned
- May 18, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 69.19 of 100
- Improvement activities
- 20
- Cost
- 77.93
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS, MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180703000748 | KS | Practitioner - Emergency Medicine | 1850647942 | Reassigns benefits to 2 organizations |
| I20201228001403 | MO | Practitioner - Emergency Medicine | 1850647942 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0440918 | KS | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Kansas Emergency Physicians, LLC | Emergency Medicine | Current |
Accepting new patients |
| Emergency Medicine Services of Mo, LLC | Emergency Medicine | Current |
Accepting new patients |
| Medevac Midamerica Inc | Past | Accepting new patients |
Locations
8929 Parallel Pkwy
Kansas City, KS 66112
Phone (913) 596-3930
3500 S 4th St
Leavenworth, KS 66048
Phone (913) 469-1411
19600 E 39th St S
Independence, MO 64057
Phone (816) 698-7000
2100 SE Blue Pkwy
Lees Summit, MO 64063
Phone (816) 282-5175
403 Burkarth Rd
Warrensburg, MO 64093
Phone (660) 474-2500
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 0440918 | KS | Yes |
Addresses
Primary practice location
711 Marshall St
Leavenworth, KS 66048-3235
Mailing address
1814 N 142ND St
Basehor, KS 66007-9660
Phone (316) 516-4048
Other practice location 1
4800 Alberta Ave
El Paso, TX 79905-2709
Phone (915) 545-6618
Other providers in Leavenworth, KS
- Danita Gail Buckingham
- Jessica Budke
- Lisa Buehler
- Robert Bugh
- Cathy Bui
- Kristen Burcham
- Elizabeth Michelle Burden
- Mary Lou Burge
- William Maxime Buron III
- Tasha Buselt
All providers in Leavenworth, KS · Emergency Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.