Samuel Mark Bullard
NPI 1649067422ActiveIndividual· Dietitian, Registered· Snellville, GA
Dietitian, Registered in Snellville, Georgia, licensed in GA, with an NPI issued in April 2025.
Overview
| NPI | 1649067422 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Apr 23, 2025 |
| Last updated in NPPES | Apr 23, 2025 |
| Certified by provider | Apr 23, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | LD006062 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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All 16 registered dietitians in Snellville · All registered dietitians in Georgia