Kristi A Bullock, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001204 Issued in IA

Practice address

5350 Eastern Ave.
Davenport, IA 52807-2709

Phone

(563) 355-1853

Fax

(563) 359-1512

NPI assigned

Feb 24, 2006

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

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1036

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.

• Obstetrics and Gynecology Specialists PC

  • Obstetrics & Gynecology Physician
  • Davenport, IA
  • NPI 1427003011
  NPD

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1760458178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 EASTERN AVE.",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072709",
            "telephone_number": "563-355-1853",
            "fax_number": "563-359-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 EASTERN AVE.",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072709",
            "telephone_number": "563-355-1853",
            "fax_number": "563-359-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "KRISTI",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Bryant, B.S., D.C.
• Meghan E Buchanan, DPT
• Mitchell R Budde
• Elizabeth Budelier
• Franlynn Bugg, PH.D.
• Scott Bullock
• Christy Lee Bulman, D.D.S.
• Casey Antony Buns, DC, CCSP
• Dean A Bunting, MD
• Ross Burandt

• Physician Assistant in Davenport, IA
• Providers in Davenport, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; 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.