TODD E BULLOCK (NPI# 1104822360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104822360 |
| Entity Type | Individual |
| Full Name | TODD E BULLOCK |
| Credential | APRN |
| Practice Address |
301 Sunset Dr Caneyville KY 42721-9172 |
| Mailing Address |
908 Wallace Ave Leitchfield KY 42754-1479 |
| Practice Telephone | 2708793711 |
| Practice Fax Number | 2708798674 |
| Mailing Telephone | 2702591626 |
| Mailing Fax Number | 2702599582 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2018-11-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3004076 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | PASSPORT | 50001589 | 01 |
| KY | PASSPORT ADVANTAGE | 2443164000 | 01 |
| KY | 78010436 | 05 | |
| KY | ANTHEM | 000000302145 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700888047 | Todd Bullock | Specialist | 138 Joerschke Dr, Grass Valley, CA 95945-5248 | 2005-06-01 |
| 1285937029 | Todd Bullock | Behavioral Analyst | 203 E 10th St, Sanford, FL 32771-2621 | 2010-12-17 |
| Street Address |
301 SUNSET DR |
| City | CANEYVILLE |
| State | KY |
| Zip Code | 42721-9172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447253786 | Robert E Mcclure | Family Medicine | 301 Sunset Dr, Caneyville, KY 42721 | 2005-05-31 |
| 1164054664 | Grayson County Hospital Foundation Inc | Clinic/Center | 301 Sunset Dr, Caneyville, KY 42721-9172 | 2020-02-12 |
| 1720164825 | Twin Lakes Medical Foundation, Inc. | Nurse Practitioner | 301 Sunset Dr, Caneyville, KY 42721-9172 | 2006-10-31 |
| 1205895943 | Gregory Thomas Koo | Specialist | 301 Sunset Dr, Caneyville, KY 42721-9172 | 2006-03-21 |
| 1013910504 | Twin Lakes Medical Foundation, Inc. | General Practice | 301 Sunset Dr, Caneyville, KY 42721-9172 | 2005-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477627057 | Mike J Utley | Dentist | 528 East Maple Street, Caneyville, KY 42721 | 2006-11-17 |
| 1467439083 | Midway Pharmacy of Clarkson, Inc | Durable Medical Equipment & Medical Supplies | 408 East Maple Street, Caneyville, KY 42721 | 2005-12-23 |
| 1770906513 | Shelly Geary | Nurse Practitioner | 4162 Falls of Rough Rd, Caneyville, KY 42721-9037 | 2014-01-30 |
| 1144769274 | Martha Gary | Behavior Technician | 527 E Maple St, Caneyville, KY 42721-9060 | 2017-02-22 |
| 1144207432 | Embry Welding Supply Inc | Durable Medical Equipment & Medical Supplies | 10 Industrial Dr, Caneyville, KY 42721-9176 | 2005-12-28 |
| 1174708705 | Embry Medical Supply | Durable Medical Equipment & Medical Supplies | 10 Industrial Dr, Caneyville, KY 42721-9176 | 2008-01-02 |
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770906513 | Shelly Geary | Nurse Practitioner | 4162 Falls of Rough Rd, Caneyville, KY 42721-9037 | 2014-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518661 | Kimberly Sue Moore | Nurse Practitioner | 1196 Sardis Rd, Mount Olivet, KY 41064-7580 | 2020-11-02 |
| 1740880640 | Kristie Lynn Hale | Nurse Practitioner | 521 East Cumberland Gap Parkway, Suite 1, Corbin, KY 40701 | 2020-10-29 |
| 1053911065 | Ashley Renee Smith | Nurse Practitioner | 8367 Stonelick Rd, Maysville, KY 41056-9432 | 2020-10-28 |
| 1629677117 | Shelby A Rollings | Nurse Practitioner | 100 Clint Hill Blvd, Paducah, KY 42001-6771 | 2020-10-26 |
| 1023618535 | Pamela Nicole Kinney | Nurse Practitioner | 13503 Terrace Creek Dr Apt 203, Louisville, KY 40245-5838 | 2020-10-26 |
| 1710586466 | Jamie Rae Ratcliff | Nurse Practitioner | 141 Ky Route 1428, Prestonsburg, KY 41653-1506 | 2020-10-23 |
| 1518566371 | Kelly Rae Smith | Nurse Practitioner | 13402 Creekview Rd, Prospect, KY 40059-9028 | 2020-10-22 |
| 1952900870 | Sarah Elizabeth Clark | Nurse Practitioner | 1309 Morning Side Ct, Lexington, KY 40509-2353 | 2020-10-21 |
| 1942809033 | Lauren Elizabeth Tobler | Nurse Practitioner | 32 Burdsall Ave, Fort Mitchell, KY 41017-2802 | 2020-10-20 |
| 1629677745 | Lisa Elaine Coleman | Nurse Practitioner | 2241 Gulfstream Dr, Lexington, KY 40504-3273 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
| City | CANEYVILLE |
| Zip Code | 42721 |
Please comment or provide details below to improve the information on TODD E BULLOCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.