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DR. KIM ALLISON BULLOCK M.D.
NPI 1609287473
Psychiatry & Neurology - Child & Adolescent Psychiatry in Mclean, VA

Active since May 15, 2014Opted out of Medicare · through May 22, 2028
1307 DOLLEY MADISON BLVD, SUITE 3-C, MCLEAN, VA 22101(703) 790-9622 Get Directions Write a Review

NPPES record last updated: May 15, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kim Allison Bullock M.d. NPPES

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

DR. KIM ALLISON BULLOCK M.D. (NPI 1609287473) is an individual child & adolescent psychiatry provider in Mclean, Virginia, licensed in Virginia (0101054045) and active in the NPI registry since May 2014. She has opted out of Medicare through May 22, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1609287473
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameDR. KIM ALLISON BULLOCKCredential: M.D.
Location Address1307 DOLLEY MADISON BLVD, SUITE 3-CMclean, VA 22101
Mailing Address1307 Dolley Madison Blvd, Suite 3-cMclean, VA 22101 · (703) 790-9622 · Fax (703) 734-7962
Phone(703) 790-9622
Sole ProprietorYes
Enumeration DateMay 15, 2014
✔ NPI 1609287473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in VA · 0101054045
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 0101054045 (VA)
1307 DOLLEY MADISON BLVD, Mclean, VA 22101
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kim Allison Bullock M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 22, 2018 through May 22, 2028.

Opt-Out Effective DateMay 22, 2018
Opt-Out In Effect ThroughMay 22, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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.

CHRISTEN M KERR MD
Psychiatry & Neurology (Psychiatry)
1307 DOLLEY MADISON BLVD, SUITE 3C
MC LEAN, VA 22101
Fairfax County (703) 734-7961
DR. CATHERINE LAPP MCCARTHY M.D.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1307 DOLLEY MADISON BLVD, SUITE 3C
MCLEAN, VA 22101
Fairfax County (703) 288-3535
DR. JOAN ADELE TURKUS M.D.
Psychiatry & Neurology (Psychiatry)
1307 DOLLEY MADISON BLVD, SUITE 3C
MCLEAN, VA 22101
Fairfax County (703) 893-3499

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 Kim Bullock's NPI number?

The NPI number for Kim Bullock is 1609287473. It was assigned to this individual provider in the NPPES registry on May 15, 2014.

Where is Kim Bullock located?

Kim Bullock practices at 1307 Dolley Madison Blvd Suite 3-C, Mclean, VA 22101. The listed phone number is (703) 790-9622.

What is Kim Bullock's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Kim Bullock enrolled in Medicare?

No. Kim Bullock has opted out of Medicare through May 22, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kim Bullock was last updated on May 15, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.