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ALICIA BULLOUGH PA-C
NPI 1215894217
Physician Assistant in Charlotte, NC

Active since January 09, 2026PECOS Enrolled
3627 BEATTIES FORD RD, CHARLOTTE, NC 28216(704) 335-0806 Get Directions Write a Review

NPPES record last updated: January 15, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 15, 2026, Jan 9, 2026 (2 updates tracked since 2026).

About Alicia Bullough Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALICIA BULLOUGH PA-C (NPI 1215894217) is an individual physician assistant in Charlotte, North Carolina and active in the NPI registry since January 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215894217
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameALICIA BULLOUGHCredential: PA-C
Location Address3627 BEATTIES FORD RDCharlotte, NC 28216-3249
Mailing Address3627 Beatties Ford RdCharlotte, NC 28216-3249
Phone(704) 335-0806
Sole ProprietorNo
Enumeration DateJanuary 9, 2026
Last NPPES UpdateJanuary 15, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 15, 2026
✔ NPI 1215894217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
3627 BEATTIES FORD RD, Charlotte, NC 28216
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alicia Bullough Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28216 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
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
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 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BOMRAY MEDICAL CLINIC
Clinic/Center (Primary Care)
3627 BEATTIES FORD RD
CHARLOTTE, NC 28216
Mecklenburg County (704) 335-0806
DR. PATRICK E EVIVIE MD
Internal Medicine
3627 BEATTIES FORD RD
CHARLOTTE, NC 28216
Mecklenburg County (704) 335-0806
DR. RAHSAN DEMARCUS MCMILLAN PT, DPT
Physical Therapist
3627 BEATTIES FORD RD
CHARLOTTE, NC 28216
Mecklenburg County (704) 394-6677
SPORTS AND SPINE PHYSICAL THERAPY NC INC
Clinic/Center (Physical Therapy)
3627 BEATTIES FORD RD
CHARLOTTE, NC 28216
Mecklenburg County (704) 394-6677

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 Alicia Bullough's NPI number?

The NPI number for Alicia Bullough is 1215894217. It was assigned to this individual provider in the NPPES registry on January 9, 2026.

Where is Alicia Bullough located?

Alicia Bullough practices at 3627 Beatties Ford Rd, Charlotte, NC 28216. The listed phone number is (704) 335-0806.

What is Alicia Bullough's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Alicia Bullough enrolled in Medicare?

Yes. Alicia Bullough is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alicia Bullough was last updated on January 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.