Mellorya Lynn Wynn Bullard, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1640 Issued in AR

Practice address

904 N Drew St
Star City, AR 71667-5730

Phone

(870) 628-3888

Fax

(870) 628-3221

NPI assigned

Dec 16, 2005

Last updated

Sep 15, 2022By the provider in NPPES

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

Enrolled in AR

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rock City Chiropractic PLLCGroup PAC ID 8921320920, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rock City Chiropractic PLLC

  dba Rock City

  • Chiropractor
  • Star City, AR
  • NPI 1912303975
  Medicare reassignment Care Compare group NPD
• Health Management of Arkansas

  • Chiropractor
  • North Little Rock, AR
  • NPI 1366632887
  NPD (past)

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1962488361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 N DREW ST",
            "city": "STAR CITY",
            "state": "AR",
            "postal_code": "716675730",
            "telephone_number": "501-231-8296",
            "fax_number": "870-628-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 N DREW ST",
            "city": "STAR CITY",
            "state": "AR",
            "postal_code": "716675730",
            "telephone_number": "870-628-3888",
            "fax_number": "870-628-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN BULLARD",
        "first_name": "MELLORYA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitehall Pharmacy LLC
• McKenna M Wilkerson, APRN
• Brittany L Wilkins, BS
• Leah Jacks Williams, APRN
• Yolanda Williams

• Chiropractor in Star City, AR
• Providers in Star City, AR by specialty
• Chiropractor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.