Active NPI
Kelvin W Bullock
- Chiropractor
- Tewksbury, MA
National Provider Identifier
1881098853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3469
- Practice address
- 1501 Main St
Tewksbury, MA 01876-4725 - Phone
- (978) 851-3987
- NPI assigned
- Oct 20, 2014
- Last updated
- Oct 20, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3469 | MA | Primary |
Addresses
Primary practice location
1501 Main St
Tewksbury, MA 01876-4725
Mailing address
1501 Main St
Tewksbury, MA 01876-4725
Phone (978) 851-3987
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3469 | MA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413763200000",
"number": "1881098853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 MAIN ST",
"city": "TEWKSBURY",
"state": "MA",
"postal_code": "018764725",
"telephone_number": "978-851-3987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 MAIN ST",
"city": "TEWKSBURY",
"state": "MA",
"postal_code": "018764725",
"telephone_number": "978-851-3987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLOCK",
"first_name": "KELVIN",
"middle_name": "W",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-20",
"last_updated": "2014-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "3469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tewksbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.