Active NPI
Erica Ann Bullard, CPNP
- Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1760992150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN208631
- Practice address
- 35 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3032 - Phone
- (404) 785-9650
- Fax
- (404) 785-9870
- NPI assigned
- Oct 11, 2017
- Last updated
- Mar 16, 2023
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN208631 | GA | Primary |
| Pediatric Emergency Medicine (Emergency Medicine) Physician | 207PP0204X | RN208631 | GA |
Addresses
Primary practice location
35 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3032
Mailing address
35 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3032
Phone (404) 785-9650
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | choa@choa.gadirect.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171130002378 | GA | Order and Referring Only - Nurse Practitioner | 5991062861 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678924800000",
"number": "1760992150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 JESSE HILL JR DR SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303033032",
"telephone_number": "404-785-9650",
"fax_number": "404-785-9870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 JESSE HILL JR DR SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303033032",
"telephone_number": "404-785-9650",
"fax_number": "404-785-9870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLARD",
"first_name": "ERICA",
"middle_name": "ANN",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-11",
"last_updated": "2023-03-16",
"certification_date": "2023-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN208631",
"primary": true
},
{
"code": "207PP0204X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Pediatric Emergency Medicine",
"state": "GA",
"license": "RN208631",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "choa@choa.gadirect.net",
"affiliation": "N",
"address_1": "35 Jesse Hill Jr Dr SE",
"city": "Atlanta",
"state": "GA",
"country_code": "US",
"postal_code": "303033032",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.