STACIE MAREE BULLOCK (CRNP) – Nurse Practitioner, NPI 1174802565
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,653 NURSE PRACTITIONER in AL
Provider Addresses for STACIE MAREE BULLOCK (CRNP)
3400 HIGHWAY 78 E
SUITE 412
JASPER, AL 355018907
Phone:
Type: Mailing
3485 INDEPENDENCE DR
BIRMINGHAM, AL 352095603
Phone: (205) 930-0920
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 43 Open Payments records for all available years, with a total value of $1,599.
Total Amount is formed as General ($1,599) + Research ($0) + Ownership ($0) = $1,599.
Last reported payment date: 2024-12-02 • Largest payer in this snapshot: Janssen Biotech, Inc. ($527).
Total Amount
$1,599
General + Research + Ownership
Payments
43
Total payment records
General Amount
$1,599
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Biotech, Inc. | $527 |
| Sumitomo Pharma America, Inc. | $230 |
| Axonics, Inc. | $221 |
| Antares Pharma, Inc. | $175 |
| Medtronic, Inc. | $155 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-09-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110912000139 | I | Nurse Practitioner | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 55866 | Surgical removal of prostate and surrounding lymph nodes using an endoscope | 17 | 17 | $0 |
| 38571 | Removal of lymph nodes of both sides of pelvis using an endoscope | 13 | 13 | $0 |
| 81003 | Automated urinalysis test | 13 | 13 | $0 |
Insurance plans in this area (ZIP 35501)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | AL | |
| U R O L O G Y | AL | |
| U R O L O G Y | AL | |
| Physician Assistant | AL | |
| U R O L O G Y | AL | |
| - | AL | |
| - | AL | |
| U R O L O G Y | AL | |
| U R O L O G Y | AL | |
| U R O L O G Y | AL |
Reviews
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