Individual provider Active NPI

Dennis E Bullard, M.D.

  • Specialist
  • Raleigh, NC
National Provider Identifier
1861495905
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
26088 Issued in NC
Practice address
1540 Sunday Dr
Ste 214
Raleigh, NC 27607-6000
Phone
(919) 235-0222
Fax
(919) 235-0227
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 26088 NC Primary

Addresses

Primary practice location

1540 Sunday Dr
Ste 214
Raleigh, NC 27607-6000

Mailing address

1540 Sunday Dr
Ste 214
Raleigh, NC 27607-6000
Phone (919) 235-0222

Other identifiers 1

IdentifierTypeStateIssuer
8919702MedicaidNC

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26088NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Neurosurgical Clinic, Inc. Past Accepting new patients
Triangle Neurosurgery Specialist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1861495905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 SUNDAY DR",
            "address_2": "STE 214",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076000",
            "telephone_number": "919-235-0222",
            "fax_number": "919-235-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 SUNDAY DR",
            "address_2": "STE 214",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076000",
            "telephone_number": "919-235-0222",
            "fax_number": "919-235-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "DENNIS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "26088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8919702",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; 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.