Active NPI
Jessica Bullis, PT, DPT
- Physical Therapist
- Albany, NY
National Provider Identifier
1982376356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 047837
- Practice address
- 314 S Manning Blvd
Albany, NY 12208-1708 - Phone
- (518) 437-5859
- NPI assigned
- Oct 4, 2021
- 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 | 047837 | NY | Primary |
Addresses
Primary practice location
314 S Manning Blvd
Albany, NY 12208-1708
Mailing address
1135 Western Ave Apt 4G
Albany, NY 12203-3341
Phone (716) 946-4832
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 |
|---|---|---|---|
| 047837 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633305600000",
"number": "1982376356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1135 WESTERN AVE APT 4G",
"city": "ALBANY",
"state": "NY",
"postal_code": "122033341",
"telephone_number": "716-946-4832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 S MANNING BLVD",
"city": "ALBANY",
"state": "NY",
"postal_code": "122081708",
"telephone_number": "518-437-5859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLIS",
"first_name": "JESSICA",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-04",
"last_updated": "2021-10-04",
"certification_date": "2021-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "047837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.