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CRYSTAL ROSE BULLARD MD
NPI 1649432469
Psychiatry & Neurology - Child & Adolescent Psychiatry in Charlotte, NC

Active since July 02, 2008Opted out of Medicare · through Jan 25, 2028
6845 FAIRVIEW RD STE 21, CHARLOTTE, NC 28210(910) 827-0535(980) 249-4142 Get Directions Write a Review

NPPES record last updated: November 14, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 14, 2024, May 4, 2023, Mar 9, 2023 and 52 more (55 updates tracked since 2018).

About Crystal Rose Bullard Md NPPES

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

CRYSTAL ROSE BULLARD MD (NPI 1649432469) is an individual child & adolescent psychiatry provider in Charlotte, North Carolina, licensed in North Carolina (2013-00024) and active in the NPI registry since July 2008. She has opted out of Medicare through January 25, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1649432469
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameCRYSTAL ROSE BULLARDCredential: MD
Location Address6845 FAIRVIEW RD STE 21Charlotte, NC 28210-3363
Mailing Address3525 Rea Forest DrCharlotte, NC 28226-3193 · (910) 827-0535
Phone(910) 827-0535
Fax(980) 249-4142
Sole ProprietorNo
Enumeration DateJuly 2, 2008
Last NPPES UpdateNovember 14, 202455 updates tracked since enumeration
NPPES CertifiedNovember 14, 2024
✔ NPI 1649432469 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 NC · 2013-00024
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 2013-00024 (NC)
6845 FAIRVIEW RD STE 21, Charlotte, NC 28210
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Crystal Rose Bullard Md 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 January 25, 2024 through January 25, 2028.

Opt-Out Effective DateJanuary 25, 2024
Opt-Out In Effect ThroughJanuary 25, 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.

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 Crystal Bullard's NPI number?

The NPI number for Crystal Bullard is 1649432469. It was assigned to this individual provider in the NPPES registry on July 2, 2008.

Where is Crystal Bullard located?

Crystal Bullard practices at 6845 Fairview Rd Ste 21, Charlotte, NC 28210. The listed phone number is (910) 827-0535.

What is Crystal Bullard's specialty?

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

Is Crystal Bullard enrolled in Medicare?

No. Crystal Bullard has opted out of Medicare through January 25, 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 Crystal Bullard was last updated on November 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.