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MRS. KIMBERLY SUE ELLEN BULLARD FNP-BC
NPI 1003772211
Nurse Practitioner - Family in Shallotte, NC

Active since December 31, 2025PECOS EnrolledAccepts Medicare Assignment
4503 MAIN ST STE 1, SHALLOTTE, NC 28470(910) 754-2273(910) 754-2254 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 5, 2026, Dec 31, 2025 (2 updates tracked since 2025).

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

NPI1003772211
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. KIMBERLY SUE ELLEN BULLARDCredential: FNP-BC
Location Address4503 MAIN ST STE 1Shallotte, NC 28470-4583
Mailing Address4503 Main St Ste 1Shallotte, NC 28470-4583 · (910) 754-2273 · Fax (910) 754-2254
Phone(910) 754-2273
Fax(910) 754-2254
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateDecember 31, 2025
Last NPPES UpdateMay 5, 20262 updates tracked since enumeration
NPPES CertifiedMay 5, 2026
✔ NPI 1003772211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NC · 5023712
4503 MAIN ST STE 1, Shallotte, NC 28470
Open in Google Maps ↗

Other Identifiers 1

Other5023712NC · State

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

PECOS PAC ID9335629682
PECOS Enrollment IDI20260216002475
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number340158
Location1 Medical Center Dr PO Box 139Supply, NC 28462 · Brunswick County
Emergency services Birthing friendly

Physician 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.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

HANNAH NICHOLSON
Nurse Practitioner (Adult Health)
4503 MAIN ST STE 1
SHALLOTTE, NC 28470
Brunswick County (910) 754-2273
RDMG ASSOCIATES PA
Family Medicine
4503 MAIN ST STE 1
SHALLOTTE, NC 28470
Brunswick County (910) 754-2273
RALEIGH DURHAM MEDICAL GROUP PA
Family Medicine
4503 MAIN ST STE 1
SHALLOTTE, NC 28470
Brunswick County (910) 754-2273

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.

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 3 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.