Active NPI
Kristin Marie Bulkley, R.D, L.D.N
- Registered Dietitian
- Plainfield, IL
National Provider Identifier
1710179544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164004687
- Practice address
- 15728 S Route 59
Plainfield, IL 60544-2693 - Phone
- (815) 436-8831
- Fax
- (815) 436-6863
- NPI assigned
- Aug 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 164004687 | IL | |
| Registered Dietitian | 133V00000X | 164004687 | IL | Primary |
Addresses
Primary practice location
15728 S Route 59
Plainfield, IL 60544-2693
Mailing address
15728 S Route 59
Plainfield, IL 60544-2693
Phone (815) 436-8831
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164004687 | Medicaid | IL | |
| P00186793 | Other | IL | RAILROAD MEDICARE PTAN |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiology Associates of Northern Illinois | Past | Accepting new patients | |
| Corwin Medical Care LTD | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Cardiovascular Disease Physician
- Joliet, IL
- NPI 1710145578
-
- Primary Care Clinic/Center
- Plainfield, IL
- NPI 1174673826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211241600000",
"number": "1710179544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15728 S ROUTE 59",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605442693",
"telephone_number": "815-436-8831",
"fax_number": "815-436-6863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15728 S ROUTE 59",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605442693",
"telephone_number": "815-436-8831",
"fax_number": "815-436-6863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULKLEY",
"first_name": "KRISTIN",
"middle_name": "MARIE",
"credential": "R.D, L.D.N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-15",
"last_updated": "2008-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "IL",
"license": "164004687",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164004687",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "164004687",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "P00186793",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plainfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.