Shirron Dobie Bullock

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202004252 Issued in VA

Practice address

255 E South Blvd
Petersburg, VA 23805

Phone

(804) 732-0510

NPI assigned

Jan 29, 2008

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 names 1

• Shirron Dobie Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dominion Physical Therapy & Associates Inc.

  • Physical Therapy Clinic/Center
  • Hampton, VA
  • NPI 1073573242

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1699952945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 DARBY DR",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238035331",
            "telephone_number": "757-814-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E SOUTH BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "23805",
            "telephone_number": "804-732-0510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "729 Thimble Shoals Blvd",
            "address_2": "suite 4c",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064217",
            "country_code": "US",
            "telephone_number": "757-873-2932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "SHIRRON",
        "middle_name": "DOBIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRRON",
            "last_name": "DOBIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charlotte Marsee Bryant, RN,C
• Building a Better Youth LLC
• Building a Better Youth LLC
• Building Better Lives Community Services
• Building Our Youth LLC
• Jocelyn L Burls, NP-C
• Shawn L Burrow, NP-C
• Baroness B Butler, LCSW
• Butterfly Horizon LLC
• Butterfly Sponsored Residential LLC

• Speech-Language Pathologist in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.