CONSTANCE R BULLOCK (FNP-C) – Family Nurse Practitioner, NPI 1104306620

CONSTANCE R BULLOCK (FNP-C) is a healthcare provider. based in Columbus, Indiana. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. MB4968143 (IN). The NPI Number for CONSTANCE R BULLOCK (FNP-C) is 1104306620

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
CONSTANCE R BULLOCK (FNP-C)
NPI
1104306620
Phone
(812) 372-8481
Address
1901 Taylor Rd
Enumeration Date
14 August 2018
Last Update Date
25 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3175883067
Graduation Year
2018 (8 years ago)
PAC ID
6002169679
Group Practice PAC ID
4385961093
Professional Enrollment ID
I20181029001300
Address ID
IN462563376IN9775XBLVD301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:7State licenses:2Digital endpointsOther names

8,192 NURSE PRACTITIONER in IN

Provider Addresses for CONSTANCE R BULLOCK (FNP-C)

  • 1901 Taylor Rd

    Columbus, IN 472033908

    Phone: (812) 372-8481

    Type: Location

  • 220 W COLFAX AVE STE 400

    SOUTH BEND, IN 466011635

    Phone: (888) 837-5440

    Type: Location

  • 3675 S US HIGHWAY 31

    FRANKLIN, IN 461318142

    Phone: (317) 418-5819

    Type: Mailing

  • 6440 W 34TH ST

    INDIANAPOLIS, IN 462241138

    Phone: (317) 293-4930

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2018-10-29

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181029001300INurse PractitionerINTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes1,072242$0
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes1,012228$0
99305Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes134131$0
99306Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes10196$0
99490Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month4527$0
View full utilization report →

Insurance plans in this area (ZIP 47203)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385961093View full group profile
NameSpecialtyState
Nurse PractitionerWI
Nurse PractitionerGA
-FL
Nurse PractitionerVA
Nurse PractitionerWI
Certified Clinical Nurse Specialist (Cns)OH
Nurse PractitionerMO
Nurse PractitionerMS
-FL
Nurse PractitionerAL

Reviews

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Frequently asked questions

What identifier follows CONSTANCE R BULLOCK (FNP-C) across health systems?
The NPI 1104306620 uniquely identifies CONSTANCE R BULLOCK (FNP-C) in U.S. healthcare data.
Is CONSTANCE R BULLOCK (FNP-C)'s NPI status active today?
Active status means CONSTANCE R BULLOCK (FNP-C)'s NPI record is not deactivated in the public file.
What services align with CONSTANCE R BULLOCK (FNP-C)'s listing?
CONSTANCE R BULLOCK (FNP-C)'s public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to CONSTANCE R BULLOCK (FNP-C)?
CONSTANCE R BULLOCK (FNP-C) is associated with Columbus, Indiana in the same public data insurers reference.
Can I export CONSTANCE R BULLOCK (FNP-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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