Jillian Bullock, C.N.A 1

Primary specialty

Nurse's AideTaxonomy code 376K00000X

Practice address

815 Sulphur Springs Rd
Warrenton, NC 27589

Phone

(252) 433-8007

Fax

(252) 436-6008

NPI assigned

Jan 23, 2007

Reactivated

Aug 16, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1891849147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 311",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275360311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 SULPHUR SPRINGS RD",
            "city": "WARRENTON",
            "state": "NC",
            "postal_code": "27589",
            "telephone_number": "252-433-8007",
            "fax_number": "252-436-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "JILLIAN",
        "name_prefix": "Ms.",
        "credential": "C.N.A 1",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2019-08-16",
        "deactivation_date": "2019-06-04",
        "reactivation_date": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beckford Avenue Medical Center PA
• Bio-Medical Applications of North Carolina, Inc.
• Cessel Jewon Boyd, MA, LCMHC, LPC
• Romine Branch
• Chelsea Lea Britt
• Marlon Bynum
• C J Boyd Christian Counseling Services PLLC
• Carolina Behavioral Care
• Delphina Charles, LCSW-A
• Sheilia Cheek, MSED/LCAS-A

• All providers in Warrenton, NC
• Nurse's Aide in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.