Individual provider Active NPI

Linsey Bullock, ARNP

  • Nurse Practitioner
  • South Whitley, IN
National Provider Identifier
1770939084
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71015472A Issued in IN
Practice address
4665 S State Road 5
South Whitley, IN 46787-9101
Phone
(260) 248-9980
Fax
(260) 248-9981
NPI assigned
May 5, 2016
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71015472A IN Primary
Family Nurse Practitioner 363LF0000X AP60635392 WA

Addresses

Primary practice location

4665 S State Road 5
South Whitley, IN 46787-9101

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other names 1

  • Linsey Branson Former name

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address lbullock660522@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240919002178 IN Practitioner - Nurse Practitioner 7719278803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

4665 S State Rd
5 PPG Family Medicine
South Whitley, IN 46787-9101
Phone (260) 248-9980

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71015472AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Nurse Practitioner CurrentSince Oct 6, 2024 Accepting new patients
New Horizons Mental Wellness Clinics Past Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

4665 S State Road 5
South Whitley, IN 46787
Phone (260) 248-9980

Interoperability endpoints

  • Direct secure messaging: lbullock660522@direct.parkviewexchange.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1770939084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4665 S STATE ROAD 5",
            "city": "SOUTH WHITLEY",
            "state": "IN",
            "postal_code": "467879101",
            "telephone_number": "260-248-9980",
            "fax_number": "260-248-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "LINSEY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-05",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71015472A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60635392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lbullock660522@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "4665 S State Road 5",
            "city": "South Whitley",
            "state": "IN",
            "country_code": "US",
            "postal_code": "467879101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4665 S State Road 5",
            "city": "South Whitley",
            "state": "IN",
            "country_code": "US",
            "postal_code": "467879101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "4665 S State Road 5",
            "city": "South Whitley",
            "state": "IN",
            "country_code": "US",
            "postal_code": "467879101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LINSEY",
            "last_name": "BRANSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Whitley, IN

Sources for this page

Verify at the official NPI Registry.