DR. THOMAS J BULLOCK (NPI# 1578907671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578907671 |
| Entity Type | Individual |
| Full Name | DR. THOMAS J BULLOCK |
| Credential | MD |
| Practice Address |
1375 E 20th Ave Denver CO 80205-5422 |
| Mailing Address |
2500 S Havana St Aurora CO 80014-1618 |
| Practice Telephone | 3033384545 |
| Mailing Telephone | 3033384545 |
| Enumeration Date | 2013-04-20 |
| Last Update Date | 2020-05-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204D00000X | Neuromusculoskeletal Medicine & OMM | BP10047662 | TX | Allopathic & Osteopathic Physicians |
| Y | 207T00000X | Neurological Surgery | DR.0058235 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | KAISER COMMERCIAL NUMBER | 028905 | 01 |
| CO | 9000149868 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366706186 | Thomas Kelton Bullock Jr. | Pharmacist | 348 Highway 90, Waveland, MS 39576-2672 | 2012-06-26 |
| 1427036979 | Thomas R. Bullock | Emergency Medicine | 750 Mount Carmel Mall, Suite 300, Columbus, OH 43222-1553 | 2006-01-05 |
| Street Address |
1375 E 20TH AVE |
| City | DENVER |
| State | CO |
| Zip Code | 80205-5422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437146115 | Vadim Fayngersh | Internal Medicine | 1375 E 20th Ave, Denver, CO 80205-5422 | 2005-09-29 |
| 1588177745 | Amber Vargo | Registered Nurse | 1375 E 20th Ave, Denver, CO 80205-5422 | 2017-11-09 |
| 1386156248 | Kaiser Foundation Health Plan of Colorado | Clinical Medical Laboratory | 1375 E 20th Ave, Denver, CO 80205-5422 | 2017-11-01 |
| 1558889626 | Jennifer Ann Outcalt | Registered Nurse | 1375 E 20th Ave, Denver, CO 80205 | 2017-09-08 |
| 1528581956 | Michelle Lynn Eisenhauer | Respiratory Therapist, Certified | 1375 E 20th Ave, Denver, CO 80205-5422 | 2017-07-18 |
| 1437681962 | Daniel Scott Stevens | Family Medicine | 1375 E 20th Ave, Denver, CO 80205-5422 | 2017-04-03 |
| 1568903383 | Tyler Ashford | Registered Nurse | 1375 E 20th Ave, Denver, CO 80205-5422 | 2017-03-13 |
| 1124563291 | Mary Grey Branan | Registered Nurse | 1375 E 20th Ave, Denver, CO 80205-5422 | 2016-12-28 |
| 1700335833 | Elizabeth C Tran | Physician Assistant | 1375 E 20th Ave, Denver, CO 80205-5422 | 2016-09-30 |
| 1538617212 | Kelsie Rae Elder | Physician Assistant | 1375 E 20th Ave, Denver, CO 80205-5422 | 2016-09-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235769233 | Abigail Eileen Taylor | Occupational Therapy Assistant | 3241 N York St, Denver, CO 80205 | 2020-01-19 |
| 1609415694 | Blushing Bodies | Clinic/Center | 2040 East 28th Ave, Denver, CO 80205 | 2019-12-23 |
| 1053966564 | Paul Deutsch | Social Worker | 3836 York St, Denver, CO 80205 | 2019-08-02 |
| 1770062085 | New Health Pain Treatment Centers, LLC | General Practice | 3605 S Teller, Englewood, CO 80205 | 2018-08-08 |
| 1710474374 | Paloma Dental | Dentist | 1225 35th Street, Denver, CO 80205 | 2018-04-19 |
| 1720516677 | Volunteers of America, Colorado Branch | Voluntary or Charitable | 2660 Larimer St., Denver, CO 80205 | 2017-05-23 |
| 1760917637 | Rino Dental | Dentist | 3258 Larimer St, Suite 300, Denver, CO 80205 | 2017-04-27 |
| 1891233193 | Barbara Jordan | Physical Therapist | 13123 East 16th Avenue, Box 295, Denver, CO 80205 | 2017-02-07 |
| 1255877635 | Kaiser Permanente | Clinic/Center | 1451 24th Street, Apt 146, Denver, CO 80205 | 2017-01-10 |
| 1255887501 | Stephanie W Kwong | Speech-Language Pathologist | 158 S Pacific Avenue, Denver, CO 80205 | 2016-08-28 |
| Find all providers in zip 80205 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477180255 | Healthone Clinic Services - Surgery Neurological LLC | Neurological Surgery | 1721 E 19th Ave Ste 500, Denver, CO 80218-1242 | 2020-03-24 |
| 1447773601 | Edin Nevzati | Neurological Surgery | 665 Clermont St, Denver, CO 80220-5023 | 2017-07-19 |
| 1902199342 | Colorado Physician Injury Network | Neurological Surgery | 1 Broadway Bldg A, Denver, CO 80203-3959 | 2011-05-18 |
| 1699821223 | Karen Rollins | Neurological Surgery | 1375 East 20th Avenue, Denver, CO 80205-5423 | 2007-01-26 |
| 1972529113 | Roderick G Lamond | Neurological Surgery | 777 E Speer Blvd Ste 200, Denver, CO 80203-4263 | 2006-07-14 |
| 1982630588 | Renatta J Osterdock | Neurological Surgery | 1601 E 19th Ave Ste 4600, Denver, CO 80218-1289 | 2006-06-24 |
| 1235165705 | Sean E Markey | Neurological Surgery | 850 E Harvard Ave Ste 255, Denver, CO 80210-5032 | 2006-06-24 |
| 1679517601 | James A. Wolter | Neurological Surgery | 2045 Franklin Street, Franklin Medical Offices - Neurosurgery, Denver, CO 80205 | 2006-06-16 |
| 1013544923 | Healthone Clinic Services - Surgery Neurological LLC | Neurological Surgery | 4700 Hale Pkwy Ste 360, Denver, CO 80220-4041 | 2020-03-23 |
| 1902432032 | Healthone Clinic Services - Surgery Neurological LLC | Neurological Surgery | 1719 E 19th Ave, Denver, CO 80218-1235 | 2020-03-20 |
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| 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.