Molly Beth Bullard, APRN

Individual provider Active NPI Nurse Practitioner · Choctaw, OK

NPI 1952129397 · NPPES record last updated Oct 2, 2024

Key facts

NPI
1952129397
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
216013 (OK)
Practice address
1664 S Choctaw Rd
Choctaw, OK 73020-6766
Phone
(405) 963-3195
NPI assigned
Oct 2, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Immediate Care of Oklahoma LLC (34 clinicians)

Practice addresses (Care Compare)

1664 S Choctaw Rd
Suite 101
Choctaw, OK 73020-6767
Phone (405) 281-2144

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241204001271 OK Practitioner - Nurse Practitioner 9931635786 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Immediate Care of Oklahoma, LLC Current
since Sep 27, 2024
Accepting new patients
Immediate Care of Oklahoma Current
since Sep 27, 2024
Accepting new patients
Immediate Care of Oklahoma LLC Current
since Oct 6, 2024
Accepting new patients

Locations

1664 S Choctaw Rd
Choctaw, OK 73020
Phone (405) 281-2144

1664 S Choctaw Rd
Ste 101
Choctaw, OK 73020
Phone (405) 281-2144

3400 W Tecumseh Rd
Ste 100
Norman, OK 73072
Phone (405) 307-6900

11808 S May Ave
Oklahoma City, OK 73170
Phone (405) 735-2370

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 216013 OK Yes

Addresses

Primary practice location

1664 S Choctaw Rd
Choctaw, OK 73020-6766

Mailing address

112 E 7TH St
Arcadia, OK 73007-9136
Phone (405) 693-3772

Other names

  • Miss Molly Harris Former name

Other providers in Choctaw, OK

All providers in Choctaw, OK · Nurse Practitioner in Oklahoma

Sources for this page

Verify at the official NPI Registry.