Active NPI
Dennis E Bullard, M.D.
- Specialist
- Raleigh, NC
National Provider Identifier
1861495905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 26088
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8919702 | Medicaid | NC |
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26088 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Neurological Surgery Physician
- Raleigh, NC
- NPI 1598702490
-
- Specialist
- Raleigh, NC
- NPI 1134670193
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.