Claire Christine Bullis

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

00000 Issued in ND

Practice address

111 9TH St S
Fargo, ND 58103-1831

Phone

(701) 212-8626

NPI assigned

Mar 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Beacon of Light House

  • Case Management Agency
  • Fargo, ND
  • NPI 1063112746
  NPD
• Lighthouse Church of Fargo

  • Case Manager/Care Coordinator
  • Fargo, ND
  • NPI 1316531817
  NPD
• Light House Recovery Services

  • Community/Behavioral Health Agency
  • Fargo, ND
  • NPI 1144920828
  NPD (past)

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1851048110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 9TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031830",
            "telephone_number": "701-212-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 9TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031831",
            "telephone_number": "701-212-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLIS",
        "first_name": "CLAIRE",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "ND",
            "license": "00000",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "ND",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251B00000X",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "347C00000X",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steve Buettner
• Irene Buhendwa, RN
• Miguel Buisan Catevilla, RPH
• Alexandra Bulga, MD
• Robert E Bulik, CRNA
• Bridgette A Bumann, CRNA
• Carol Ann Bunker, LPN
• Alison Bunnell
• Tyler Burcham, DPT
• Kayla Jo Burchill, MD

• Peer Specialist in Fargo, ND
• Providers in Fargo, ND by specialty
• Peer Specialist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.