DR. PONCE D BULLARD JR. (NPI# 1609897313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609897313 |
| Entity Type | Individual |
| Full Name | DR. PONCE D BULLARD JR. |
| Credential | MD |
| Practice Address |
2728 Sunset Blvd Suite 310 West Columbia SC 29169 |
| Practice Telephone | 8039368080 |
| Practice Fax Number | 8039368079 |
| Mailing Telephone | 8039368080 |
| Mailing Fax Number | 8039368079 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2012-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 7127 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 071273 | 05 | |
| RR MEDICARE | 990011971 | 01 |
| Street Address |
2728 SUNSET BLVD SUITE 310 |
| City | WEST COLUMBIA |
| State | SC |
| Zip Code | 29169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528066909 | Lynn Moore Tucker | Surgery | 2728 Sunset Blvd, Suite 104, West Columbia, SC 29169-4840 | 2005-07-11 |
| 1063019453 | Lexington Health Inc | Durable Medical Equipment & Medical Supplies | 2728 Sunset Blvd, West Columbia, SC 29169-4840 | 2020-10-08 |
| 1265979827 | Jennifer Kathleen Marsh | Nurse Practitioner | 2728 Sunset Blvd, Suite 300, West Columbia, SC 29169-4840 | 2017-01-20 |
| 1699217810 | Katelyn H Call | Nurse Practitioner | 2728 Sunset Blvd, Suite 300, West Columbia, SC 29169-4840 | 2016-11-07 |
| 1912399742 | Shannon Uyeda Burrell | Nurse Practitioner | 2728 Sunset Blvd, Suite 300, West Columbia, SC 29169-4840 | 2015-03-03 |
| 1033469176 | Lexington County Health Services District, Inc. | Surgery | 2728 Sunset Blvd, Ste 105, West Columbia, SC 29169 | 2012-09-17 |
| 1134362320 | Todd Samuel Lefkowitz | Surgery | 2728 Sunset Blvd, Ste 105, West Columbia, SC 29169 | 2009-04-17 |
| 1417119017 | South Carolina Heart Center Pa | Internal Medicine | 2728 Sunset Blvd, Ste 401, West Columbia, SC 29169-4840 | 2008-06-26 |
| 1033393145 | Lexington County Health Services District, Inc. | Obstetrics & Gynecology | 2728 Sunset Blvd, Suite 106, West Columbia, SC 29169 | 2007-12-26 |
| 1013197631 | Truesdale & Morrow Urology | Urology | 2728 Sunset Blvd, Suite 301, West Columbia, SC 29169-4840 | 2007-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960726 | Jerry Scott Oreilly | Physical Therapy Assistant | 100 Dreher Rd, Suite 100, West Columbia, SC 29169 | 2020-07-23 |
| 1134759921 | A&m Medical, LLC | Durable Medical Equipment & Medical Supplies | 1053 Sunset Boulevard, West Columbia, SC 29169 | 2020-01-21 |
| 1750946067 | First Physical Therapy, LLC | Clinic/Center | 100 Dreher Rd., Suite 100, West Columbia, SC 29169 | 2019-05-02 |
| 1295217545 | Tynaka Kwans Wilson | Nurse Practitioner | Sc House Calls Inc, 1053 Center Street, West Columbia, SC 29169 | 2018-09-04 |
| 1588183826 | Kimberly Jane Jennings | Registered Nurse | 1052 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-09-19 |
| 1164943213 | Jacob Luke Wayland | Emergency Medicine | Lexington Medical Center-emergency Medicine Dept, 2720 Sunset Blvd, West Columbia, SC 29169 | 2017-06-29 |
| 1740721232 | Heather Detwiler | Physical Therapy Assistant | 2705 Leaphart Rd., Carolina Gardens, West Columbia, SC 29169 | 2017-03-16 |
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1407252331 | Sandy Frye Boone | Counselor | 2318 Sunset Blvd # 2a, West Columbia, SC 29169 | 2014-11-04 |
| Find all providers in zip 29169 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699062380 | Lexington County Health Services District, Inc. | Obstetrics & Gynecology | 110 E Medical Lane, Ste 220, West Columbia, SC 29169 | 2011-07-01 |
| 1861677882 | Lexington County Health Services District, Inc. | Obstetrics & Gynecology | 728 Sunset Blvd, Suite 103, West Columbia, SC 29169 | 2008-01-09 |
| 1912919770 | Frederick B Thompson | Obstetrics & Gynecology | 222 E. Medical Lane, Suite 300, West Columbia, SC 29169-4837 | 2006-08-12 |
| 1255359725 | Lexington County Health Services District, Inc. | Obstetrics & Gynecology | 222 East Medical Lane, Ste 300, West Columbia, SC 29169 | 2006-07-17 |
| 1265401772 | Charles F Shipley IIi | Obstetrics & Gynecology | 2728 Sunset Blvd., Suite 106, West Columbia, SC 29169 | 2006-03-16 |
| 1730157058 | Andrea M Pezzella | Obstetrics & Gynecology | 115 Midlands Ct, West Columbia, SC 29169-3456 | 2006-03-11 |
| 1316918709 | Julie A Reed | Obstetrics & Gynecology | 146 E Hospital Dr Ste 240, West Columbia, SC 29169-4800 | 2006-02-01 |
| 1497735757 | Thomas Patrick Giudice | Obstetrics & Gynecology | 2728 Sunset Blvd Ste 201, West Columbia, SC 29169-4837 | 2006-01-20 |
| 1417932351 | Freddie Reynolds | Obstetrics & Gynecology | 3020 Sunset Blvd, Ste 105, West Columbia, SC 29169-3494 | 2005-12-14 |
| 1528040375 | Gregory E. Lyman | Obstetrics & Gynecology | 222 E Medical Ln Ste 300, West Columbia, SC 29169-4848 | 2005-11-17 |
| Find all providers in WEST COLUMBIA | ||||
| City | WEST COLUMBIA |
| Zip Code | 29169 |
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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.