ANTHONY B BULLARD MD
Complete NPI Record 1376590927
Radiology - Diagnostic Radiology in Grand Junction, CO
Quality Rating: 82.18 out of 100 score
NPI Status: Active since May 28, 2006
- NPI
- Entity Type Code
- Provider Last Name Legal Name
- Provider First Name
- Provider Middle Name
- Provider Credential Text
- Provider First Line Business Mailing Address
- Provider Second Line Business Mailing Address
- Provider Business Mailing Address City Name
- Provider Business Mailing Address State Name
- Provider Business Mailing Address Postal Code
- Provider Business Mailing Address Country Code If outside U S
- Provider Business Mailing Address Telephone Number
- Provider First Line Business Practice Location Address
- Provider Business Practice Location Address City Name
- Provider Business Practice Location Address State Name
- Provider Business Practice Location Address Postal Code
- Provider Business Practice Location Address Country Code If outside U S
- Provider Business Practice Location Address Telephone Number
- Provider Enumeration Date
- Last Update Date
- Provider Gender Code
- Healthcare Provider Taxonomy Code 1
- Provider License Number 1
- Provider License Number State Code 1
- Healthcare Provider Primary Taxonomy Switch 1
- Healthcare Provider Taxonomy Code 2
- Provider License Number 2
- Provider License Number State Code 2
- Healthcare Provider Primary Taxonomy Switch 2
- Healthcare Provider Taxonomy Code 3
- Provider License Number 3
- Provider License Number State Code 3
- Healthcare Provider Primary Taxonomy Switch 3
- Other Provider Identifier 1
- Other Provider Identifier Type Code 1
- Other Provider Identifier State 1
- Is Sole Proprietor
- NPI Certification Date
Complete NPI Dataset
This page represents the complete record for NPI 1376590927. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.
- NPI: 1376590927
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: BULLARD
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: ANTHONY
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: B
- The middle name of the provider, if the provider is an individual.
- Provider Credential Text: MD
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: 2530 N 8TH ST
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Second Line Business Mailing Address: #101
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Mailing Address City Name: GRAND JUNCTION
- The country code in the location address of the provider being identified.
- Provider Business Mailing Address State Name: CO
- The telephone number associated with the location address of the provider being identified.
- Provider Business Mailing Address Postal Code: 815018857
- The date the provider was assigned a unique identifier (assigned an NPI).
- Provider Business Mailing Address Country Code If outside U S : US
- The date that a record was last updated or changed.
- Provider Business Mailing Address Telephone Number: 9702419729
- The code designating the provider's gender if the provider is a person.
- Provider First Line Business Practice Location Address: 2635 N 7TH ST
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider Business Practice Location Address City Name: GRAND JUNCTION
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider Business Practice Location Address State Name: CO
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Provider Business Practice Location Address Postal Code: 815018209
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Provider Business Practice Location Address Country Code If outside U S : US
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
- Provider Business Practice Location Address Telephone Number: 9702419729
- The telephone number associated with the location address of the provider being identified.
- Provider Enumeration Date: 5/28/2006
- The date the provider was assigned a unique identifier (assigned an NPI).
- Last Update Date: 8/19/2024
- The date that a record was last updated or changed.
- Provider Gender Code: M
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 2085R0202X
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 44912
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: CO
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 2085R0202X
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: C1-0025098
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: DE
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: N
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 3: 2085R0202X
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 3: T8401
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 3: TX
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 3: Y
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 50324551
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: CO
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Sole Proprietor: N
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
- NPI Certification Date: 8/19/2024
- The date on which the National Provider Identifier (NPI) was officially assigned and certified to the provider. This reflects when the provider's NPI record first became active in the NPPES system.