NPIMap

Individual provider Active NPI

Kelly Bullard, DO

  • Family Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1831726975
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2023-01949 Issued in NC
Practice address
413 Owen Dr Ste 201
Fayetteville, NC 28304-3490
Phone
(910) 323-9111
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2023-01949 NC Primary

Addresses

Primary practice location

413 Owen Dr Ste 201
Fayetteville, NC 28304-3490

Mailing address

413 Owen Dr Ste 201
Fayetteville, NC 28304-3490
Phone (910) 323-9111

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
I20240306000836 NC Practitioner - Family Practice 7214359868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Arts Family Practice PAGroup PAC ID 3072580182, 5 clinicians

Practice addresses (Care Compare)

413 Owen Dr
Suite 201
Fayetteville, NC 28304-3490
Phone (910) 323-9111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.86 of 100Reported as group
Quality
88.98
Promoting interoperability
100
Improvement activities
40
Cost
87.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2023-01949NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Arts Family Practice, PA Family Medicine CurrentSince Feb 1, 2024 Accepting new patients
Cape Fear Valley Health Medical Group LLC Family Medicine PastSince Feb 1, 2024 Accepting new patients

Locations

413 Owen Dr
Ste 201
Fayetteville, NC 28304
Phone (910) 323-9111

Interoperability endpoints

  • Direct secure messaging: kelly.bullard@mafp.eclinicaldirectplus.com

Organizations & group practices 3

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1831726975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 OWEN DR STE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043490",
            "telephone_number": "910-323-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 OWEN DR STE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043490",
            "telephone_number": "910-323-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "KELLY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-01949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.