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

Shay Bullock, NP-C

Individual provider Family Medicine Physician · NPI 1366101743

Shay Bullock, NP-C is a Nurse Practitioner in Fort Hall, Idaho. Qualified in 2018, 8 years ago. Practices with Not Tsoo Gah Nee Indian Health, a 5-clinician group and accepts Medicare assignment. Licensed in Nevada.

Years since qualifying
8
Licensed in
NV
In the registry since
2021
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

See every abbreviation used in this directory →

Practice location Address checks out

33 N Mission Rd
Fort Hall, ID 83203
Phone: (208) 380-9727
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 812099 (NV)

Record details

NPI number1366101743
Entity typeIndividual (Type 1)
GenderMale
Credentials NP-C
Sole proprietorNo
NPI enumeratedDecember 13, 2021
Last updated in NPPESJuly 20, 2022
Certification dateJuly 8, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Not Tsoo Gah Nee Indian Health — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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