Active NPI
Kaitlyn Elizabeth Bullock, FNP-C
- Nurse Practitioner
- Taunton, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN2324940
- Practice address
- 2005 Bay St
Taunton, MA 02780-1085 - Phone
- (508) 828-7000
- NPI assigned
- Feb 16, 2022
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN2324940 | MA | Primary |
Addresses
Primary practice location
2005 Bay St
Taunton, MA 02780-1085
Mailing address
7 Marthas Vineyard Dr
Mattapoisett, MA 02739-1810
Phone (774) 291-9470
Other practice location 1
208 Mill Rd
Fairhaven, MA 02719-5208
Phone (774) 291-9470
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
208 Mill Rd
Fairhaven, MA 02719-5208
Phone (508) 758-3781
Hospital & facility affiliations
- Southcoast Hospitals Group
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steward Medical Group, Inc | Current | Accepting new patients | |
| Southcoast Physicians Group, Inc. | Current | Accepting new patients | |
| Southcoast Physicians Group, Inc. | Current | Accepting new patients | |
| Steward Medical Group, Inc | Current | Accepting new patients | |
| Southcoast Physicians Group, Inc. | Current | Accepting new patients |
Locations
11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442
200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000
208 Mill Rd
Fairhaven, MA 02719
Phone (508) 758-3781
208 Mill Rd
#C
Fairhaven, MA 02719
534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766
100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157
2005 Bay St
Taunton, MA 02780
Phone (508) 822-2266
Interoperability endpoints
- kbullock70985@direct.southcoast.org
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Fairhaven, MA
- NPI 1336137629
-
- Specialist
- Watertown, MA
- NPI 1629398219
-
- Emergency Medicine Physician
- Fairhaven, MA
- NPI 1861830143
-
- Orthopaedic Surgery Physician
- North Dartmouth, MA
- NPI 1902201536
-
- Specialist
- Brighton, MA
- NPI 1356654495
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wareham, MA
- NPI 1922024835
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725148800000",
"number": "1992450118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 MARTHAS VINEYARD DR",
"city": "MATTAPOISETT",
"state": "MA",
"postal_code": "027391810",
"telephone_number": "774-291-9470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2005 BAY ST",
"city": "TAUNTON",
"state": "MA",
"postal_code": "027801085",
"telephone_number": "508-828-7000"
}
],
"practiceLocations": [
{
"address_1": "208 Mill Rd",
"address_purpose": "LOCATION",
"city": "Fairhaven",
"state": "MA",
"postal_code": "027195208",
"country_code": "US",
"telephone_number": "774-291-9470",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BULLOCK",
"first_name": "KAITLYN",
"middle_name": "ELIZABETH",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-16",
"last_updated": "2024-09-01",
"certification_date": "2024-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "RN2324940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Taunton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.