NPIMap

Individual provider Active NPI

Cody Bullington

  • Physician Assistant
  • Crown Point, IN
National Provider Identifier
1841093085
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004800A Issued in IN
Practice address
12750 Saint Francis Dr
Crown Point, IN 46307-0264
Phone
(219) 738-2100
NPI assigned
Mar 31, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004800A IN Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

12750 Saint Francis Dr
Crown Point, IN 46307-0264

Mailing address

12750 Saint Francis Dr
Crown Point, IN 46307-0264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250514001834 IN Practitioner - Physician Assistant 4981122959 Reassigns benefits to 2 organizations
I20260218004319 VA Practitioner - Physician Assistant 4981122959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarksville Physician Services PCGroup PAC ID 3476937756, 31 clinicians
Roanoke Valley Healthcare Partners LLCGroup PAC ID 0143490326, 53 clinicians

Practice addresses (Care Compare)

1141 Hospital Dr NW
Corydon, IN 47112-2164
Phone (812) 738-4251

12731 Stone Village Way
Midlothian, VA 23113-2722
Phone (804) 379-1500

12750 Saint Francis Dr
Crown Point, IN 46307-0264
Phone (219) 738-2100

Hospital & facility affiliations

  • Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126
  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roanoke Valley Healthcare Partners, LLC CurrentSince Jan 28, 2026 Accepting new patients
Short Pump Family Care, LLC CurrentSince Jan 28, 2026 Accepting new patients
Blue Ridge Healthcare Partners, LLC Past Accepting new patients

Locations

12731 Stone Village Way
Midlothian, VA 23113
Phone (804) 379-1500

602 Brandon Ave SW
Ste 222
Roanoke, VA 24015
Phone (540) 774-0000

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 12

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": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1841093085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12750 SAINT FRANCIS DR",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463070264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 SAINT FRANCIS DR",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463070264",
            "telephone_number": "219-738-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLINGTON",
        "first_name": "CODY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004800A",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.