Active NPI
Theodore Joseph Bullock, D.C.
- Chiropractor
- Charlotte, NC
National Provider Identifier
1801077284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3787
- Practice address
- 8035 Providence Rd Ste 305
Charlotte, NC 28277-8914 - Phone
- (704) 341-3341
- NPI assigned
- Nov 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3787 | NC | Primary |
Addresses
Primary practice location
8035 Providence Rd Ste 305
Charlotte, NC 28277-8914
Mailing address
8035 Providence Rd Ste 305
Charlotte, NC 28277-8914
Phone (704) 341-3341
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3787 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194998400000",
"number": "1801077284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8035 PROVIDENCE RD STE 305",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282778914",
"telephone_number": "704-341-3341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8035 PROVIDENCE RD STE 305",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282778914",
"telephone_number": "704-341-3341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLOCK",
"first_name": "THEODORE",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-14",
"last_updated": "2007-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "3787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.