David Christian Bullard, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2906 Issued in NC

Practice address

2830 Maplewood Avenue
Suite a
Winston Salem, NC 27103-4114

Phone

(336) 659-2448

Fax

(336) 659-2449

NPI assigned

Apr 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Ashleybrook Clinic PA

  • Mental Health Counselor
  • Winston Salem, NC
  • NPI 1699828475
  NPD (past)
• Midlands Neurology & Pain Assoc, P.a

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Columbia, SC
  • NPI 1699280644
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1952526360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 ROBINHOOD RD",
            "address_2": "PMB #302",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065404",
            "telephone_number": "336-659-2448",
            "fax_number": "336-659-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 MAPLEWOOD AVENUE",
            "address_2": "SUITE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034114",
            "telephone_number": "336-659-2448",
            "fax_number": "336-659-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "DAVID",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000595",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Building Healthy Health Care LLC
• Built From Love in Home Care LLC
• Thomas Anthony Bull, O.D.
• Marilyn McGrath Bullaboy, PA-C
• Andrew Gray Bullard, MD
• Graham Wesley Bullard, MD
• Casey Wynne Buller
• Christopher T. Bullers, M.D.
• Erin Bullington, LPC
• Brice Andrew Bulotovich

• Clinical Psychologist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.

Verify at the official NPI Registry.