NPIMap

Individual provider Active NPI

Remus B Bullard III, PA-C

  • Physician Assistant
  • Hickory, NC
National Provider Identifier
1790728145
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102375 Issued in NC
Practice address
311 9TH Avenue Dr NE
Hickory, NC 28601-3829
Phone
(828) 322-7338
Fax
(828) 304-6319
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 102375 NC Primary

Addresses

Primary practice location

311 9TH Avenue Dr NE
Hickory, NC 28601-3829

Mailing address

311 9TH Avenue Dr NE
Hickory, NC 28601-3829
Phone (828) 322-7338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050706000939 NC Practitioner - Physician Assistant 1456397942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Endocrinology, PAGroup PAC ID 0042284903, 3 clinicians

Practice addresses (Care Compare)

311 9TH Ave Dr NE
Hickory, NC 28601-3829
Phone 8283227338112

Hospital & facility affiliations

  • Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143
  • Blue Ridge Healthcare Hospitals, Inc Hospital, Morganton, NC, CCN 340075

Merit-based Incentive Payment System (MIPS)

Final score
82.2 of 100Reported as group
Quality
73.27
Improvement activities
40
Cost
76.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
102375NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hickory Internal Medicine, Hypertension & Renal Associates Past Accepting new patients
William Lee Young III Past Accepting new patients
Extended Care Physicians - Mountain, PA Physician Assistant Past Accepting new patients
Extended Care Physicians - Piedmont, PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rbullard@pe.gwaydirect.com
  • Direct secure messaging: piedmontendocrinology.remusbullard@146280.advancedmd-direct.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1790728145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 9TH AVENUE DR NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013829",
            "telephone_number": "828-322-7338",
            "fax_number": "828-304-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 9TH AVENUE DR NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013829",
            "telephone_number": "828-322-7338",
            "fax_number": "828-304-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "REMUS",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.