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

Individual provider Physician Assistant · NPI 1932617743

Jonathan Bullock, PA-C is a Physician Assistant in Greenville, North Carolina. Qualified in 2017, 9 years ago. Practices with Vidant Medical Group LLC, a 974-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
9
Licensed in
NC
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone: (252) 847-4100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-07816 (NC)

Record details

NPI number1932617743
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 15, 2018
Last updated in NPPESMay 23, 2021
Certification dateMay 23, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Vidant Medical Group Llc — 974 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Greenville