Active NPI
Kimberly Sue Bullock, PT
- Physical Therapist
- Columbus, ND
National Provider Identifier
1902014244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT4991
- Practice address
- 3000 Bethel Rd.
Columbus, ND 43220 - Phone
- (614) 734-7014
- NPI assigned
- May 18, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT4991 | OH | Primary |
Addresses
Primary practice location
3000 Bethel Rd.
Columbus, ND 43220
Mailing address
348 Piedmont Rd
Columbus, OH 43214-3816
Phone (614) 447-9498
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT4991 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902014244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "348 PIEDMONT RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432143816",
"telephone_number": "614-447-9498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 BETHEL RD.",
"city": "COLUMBUS",
"state": "ND",
"postal_code": "43220",
"telephone_number": "614-734-7014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLOCK",
"first_name": "KIMBERLY",
"middle_name": "SUE",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT4991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.