Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kelly Leigh Bullock, DO

Individual provider Family Medicine Physician · NPI 1407941057

Dr. Kelly Leigh Bullock, DO is a Family Practice in Randolph, Nebraska. Qualified in 2000, 26 years ago. Practices with Osmond General Hospital Inc, a 7-clinician group and accepts Medicare assignment. Licensed in Nebraska.

Years since qualifying
26
Licensed in
NE
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

106 E Wayne St
Randolph, NE 68771-5300
Phone: (402) 337-0200
Fax: (402) 337-1020
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 461 (NE)

Record details

NPI number1407941057
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedOctober 3, 2006
Last updated in NPPESFebruary 15, 2022
Certification dateFebruary 15, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Osmond General Hospital Inc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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