TRAVIS L. BULLOCK MD – NPI #1699810507
Urology

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Health Care Provider Taxonomy Code for Urology

TRAVIS BULLOCK is an urologist located in SAINT LOUIS, MO. NPPES has assigned the NPI number 1699810507 to TRAVIS BULLOCK on February 20, 2007. It is a Type-1 NPI, indicating this NPI number is associated with an individual. He is also known by his other name LESLIE TRAVIS BULLOCK. According to the NPI data, there are 2 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 208800000X from the Health Care Provider Taxonomy code set, which is classified as Urology.

The NPI profile was last updated on Aug 18, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for TRAVIS BULLOCK below.

NPI Profile for
TRAVIS L. BULLOCK

NPI Number
1699810507
Enumeration Date

(more than 19 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
TRAVIS L. BULLOCK
Other Name: LESLIE TRAVIS BULLOCK
Credentials
MD
Primary location
12855 N 40 DR STE 350
SAINT LOUIS, MO 63141-8669
Phone: (314) 567-6071 Fax: (314) 567-3321
2 Other location(s):
6812 State Route 162 Ste 200
Maryville, IL 62062-8562
Phone: (618) 288-0900
111 Saint Lukes Center Dr Ste 40
Chesterfield, MO 63017-3509
Phone: (314) 567-6071
Mailing address
12855 N. FORTY DR.
STE 375
ST. LOUIS, MO 63141
Phone: (314) 567-6071 Fax: (314) 567-3321
Sole Proprietor
No
Updated
Certification Date
Aug 18, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208800000X
- Urology (Primary)		 MO 2007030776

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2
Endpoint type
FHIR URL
Endpoint Description
BJC
Content Type
CSV
Affiliation
Y
Endpoint Location
12855 N. FORTY DR.,
ST. LOUIS, MO 77025-1669

Additional Information

Education
EASTERN VIRGINIA MEDICAL SCHOOL - Graduated 2002
Offers Telehealth Services
Yes - Telehealth services allows you to talk to your health care provider using audio/video communications, such as Zoom, without actually going in to the doctor's office
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
TRAVIS BULLOCK is affiliated with the following medical group(s):
  • HOSPITAL
    • ANDERSON HOSPITAL
      6800 STATE ROUTE 162
      MARYVILLE, IL 62062
    • HSHS ST ELIZABETH'S HOSPITAL
      ONE ST ELIZABETH BOULEVARD
      O FALLON, IL 62269
    • MEMORIAL HOSPITAL
      4500 MEMORIAL DRIVE
      BELLEVILLE, IL 62226
    • MISSOURI BAPTIST MEDICAL CENTER
      3015 N BALLAS RD
      TOWN AND COUNTRY, MO 63131
  • INPATIENT REHABILITATION FACILITY
    • SSM HEALTH REHABILITATION HOSPITAL
      1027 BELLEVUE AVENUE
      RICHMOND HEIGHTS, MO 63117

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

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Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.