Kailyn Marie Bundren

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-161507 Issued in AL

Practice address

502 Governors Dr SW
Huntsville, AL 35801-5126

Phone

(256) 533-0833

NPI assigned

Jun 20, 2021

Last updated

Oct 15, 2024By 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

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Rural Urgent Care LLC

  • Urgent Care Clinic/Center
  • Centre, AL
  • NPI 1932586476
  Medicare reassignment NPD
• Rural Urgent Care LLC

  dba MainStreet Family Care

  • Rural Health Clinic/Center
  • Eufaula, AL
  • NPI 1588450316
  NPD

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

{
    "created_epoch": "1624147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1699344143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 GOVERNORS DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015126",
            "telephone_number": "256-533-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 GOVERNORS DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015126",
            "telephone_number": "256-533-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDREN",
        "first_name": "KAILYN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-20",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-161507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Leigh Bullock, CRNP
• Geoffrey A Bullock, OD
• Rebekah Kate Bullock, PMHNP-BC
• Tiffany Bumpus, CRNP
• Gail L Bundow, MD
• Lawrence H. Bundrick, MD
• Jamie Victoria Bunis, D.C.
• Jennifer Bunn, CRNP
• Susan Gaillard Bunyard, SLP-CCC
• Allee Elizabeth Burch

• Nurse Practitioner in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.