Active NPI
Lisa Jean Bullock
- Homemaker
- Germantown, OH
National Provider Identifier
1700658564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 14727 Baden Rd
Germantown, OH 45327-9407 - Phone
- (937) 604-1811
- NPI assigned
- Oct 25, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | Primary |
Addresses
Primary practice location
14727 Baden Rd
Germantown, OH 45327-9407
Mailing address
14727 Baden Rd
Germantown, OH 45327-9407
Phone (937) 604-1811
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698192000000",
"number": "1700658564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14727 BADEN RD",
"city": "GERMANTOWN",
"state": "OH",
"postal_code": "453279407",
"telephone_number": "937-604-1811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14727 BADEN RD",
"city": "GERMANTOWN",
"state": "OH",
"postal_code": "453279407",
"telephone_number": "937-604-1811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLOCK",
"first_name": "LISA",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-25",
"last_updated": "2023-10-25",
"certification_date": "2023-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.