MRS. KIMBERLY SUE ELLEN BULLARD FNP-BC
NPI 1003772211
Nurse Practitioner - Family in Shallotte, NC
About Mrs. Kimberly Sue Ellen Bullard Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KIMBERLY SUE ELLEN BULLARD FNP-BC (NPI 1003772211) is an individual family provider in Shallotte, North Carolina, licensed in North Carolina (5023712) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS, is affiliated with Novant Health Brunswick Medical Center, and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Kimberly Sue Ellen Bullard Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kimberly Bullard reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Asheville, NC 28803
- Reassigned Medicare billing, North Carolina enrollment
- 20 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Novant Health Brunswick Medical Center
Acute Care Hospitals · Supply, NCPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 28470 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kimberly Bullard's NPI number?
The NPI number for Kimberly Bullard is 1003772211. It was assigned to this individual provider in the NPPES registry on December 31, 2025.
Where is Kimberly Bullard located?
Kimberly Bullard practices at 4503 Main St Ste 1, Shallotte, NC 28470. The listed phone number is (910) 754-2273.
What is Kimberly Bullard's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kimberly Bullard enrolled in Medicare?
Yes. Kimberly Bullard is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kimberly Bullard's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Bullard reassigns Medicare benefits to Rdmg Associates PA (Asheville, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Bullard's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kimberly Bullard accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and AmeriHealth Caritas Next and 3 other insurers list Kimberly Bullard as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Kimberly Bullard affiliated with any hospitals?
According to CMS data, Kimberly Bullard is affiliated with Novant Health Brunswick Medical Center.
When was this NPI record last updated?
The NPPES record for Kimberly Bullard was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Kimberly Sue Ellen Bullard, FNP-BC · NPI 1003772211
Family physician in Shallotte, North Carolina. Individual provider, active in the CMS NPPES registry since December 31, 2025.
## Identity
- **NPI:** 1003772211 (Entity type: Individual)
- **Enumerated:** December 31, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 5023712 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 4503 MAIN ST STE 1, Shallotte, NC 28470-4583
- **Phone:** (910) 754-2273 · **Fax:** (910) 754-2254
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Rdmg Associates PA (NPI 1386195865, Asheville, NC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** May 5, 2026
- **Other identifiers:** Other 5023712 (NC)
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Source: [NPI Profile](https://npiprofile.com/npi/1003772211) · Data from the CMS NPPES public registry.