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MR. TY A. BULLINGTON NP
NPI 1407015951
Nurse Practitioner - Pediatrics in Duluth, GA

Active since June 09, 2008PECOS Enrolled
3650 STEVE REYNOLDS BLVD, DULUTH, GA 30096(404) 365-0966 Get Directions Write a Review

NPPES record last updated: October 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Ty A. Bullington Np NPPES

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

MR. TY A. BULLINGTON NP (NPI 1407015951) is an individual pediatrics provider in Duluth, Georgia, licensed in Georgia (APRN-NP242862) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407015951
Entity TypeIndividualMale
Primary Taxonomy363LP0200X
Provider Legal NameMR. TY A. BULLINGTONCredential: NP
Location Address3650 STEVE REYNOLDS BLVDDuluth, GA 30096-4506
Mailing Address1074 Peachtree Walk Ne Unit B211Atlanta, GA 30309-3949 · (615) 293-2958
Phone(404) 365-0966
Sole ProprietorNo
Enumeration DateJune 9, 2008
Last NPPES UpdateOctober 22, 2025
NPPES CertifiedOctober 22, 2025
✔ NPI 1407015951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in GA · APRN-NP242862
3650 STEVE REYNOLDS BLVD, Duluth, GA 30096
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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)

Mr. Ty A. Bullington Np 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 30096 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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 20

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

DR. DANIEL CRAIG GRIZZLE M.D.
Family Medicine
3650 STEVE REYNOLDS BLVD, KAISER PERMANENTE GWINNETT MEDICAL CENTER
DULUTH, GA 30096
Gwinnett County (770) 931-6220
SHAWNAY NICOLE MAZELL M.D.
Psychiatry & Neurology (Neurology)
3650 STEVE REYNOLDS BLVD
DULUTH, GA 30096
Gwinnett County (678) 549-6257
PATRICIA BEATRIZ MASSO MALDONADO AUD
Audiologist
3650 STEVE REYNOLDS BLVD
DULUTH, GA 30096
Gwinnett County (404) 365-0966
MS. MICHELLE S BERKOWITZ CNM
Midwife
3650 STEVE REYNOLDS BLVD, DEPARTMENT OF OBSTETRICS & GYNECOLOGY
DULUTH, GA 30096
Gwinnett County (770) 931-6110
LINDA H REMLINGER CNP
Pediatrics
3650 STEVE REYNOLDS BLVD, PEDIATRICS HEALTH CARE TEAM A
DULUTH, GA 30096
Gwinnett County (770) 931-6012
DR. TERI L LAURENTI PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3650 STEVE REYNOLDS BLVD
DULUTH, GA 30096
Gwinnett County (770) 931-6176
KELLEY WAGES STARNES CNM
Midwife
3650 STEVE REYNOLDS BLVD, KAISER PERMANENTE GWINNETT MEDICAL CENTER
DULUTH, GA 30096
Gwinnett County (770) 931-6110
LESLIE JEAN QUACKENBUSH LCSW
Social Worker (Clinical)
3650 STEVE REYNOLDS BLVD, GWINNETT COMPREHENSIVE MEDICAL CENTER
DULUTH, GA 30096
Gwinnett County (919) 764-2000

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 Ty Bullington's NPI number?

The NPI number for Ty Bullington is 1407015951. It was assigned to this individual provider in the NPPES registry on June 9, 2008.

Where is Ty Bullington located?

Ty Bullington practices at 3650 Steve Reynolds Blvd, Duluth, GA 30096. The listed phone number is (404) 365-0966.

What is Ty Bullington's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Ty Bullington enrolled in Medicare?

Yes. Ty Bullington is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ty Bullington was last updated on October 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.