Active NPI
Gary Kulak, M.D.
- Behavior Analyst
- Saint Louis, MO
National Provider Identifier
1003048265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2002002061
- Practice address
- 970 N Spoede Rd
37
Saint Louis, MO 63146-5567 - Phone
- (314) 991-9139
- NPI assigned
- Aug 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2002002061 | MO | Primary |
Addresses
Primary practice location
970 N Spoede Rd
37
Saint Louis, MO 63146-5567
Mailing address
970 N Spoede Rd
37
Saint Louis, MO 63146-5567
Phone (314) 991-9139
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 193400000X | Other | MO | RETIRED-PSYCHIATRIST |
Other names 1
- Dr. Gary Kulak
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002002061 | MO | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250726400000",
"number": "1003048265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "970 N SPOEDE RD",
"address_2": "37",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631465567",
"telephone_number": "314-991-9139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "970 N SPOEDE RD",
"address_2": "37",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631465567",
"telephone_number": "314-991-9139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KULAK",
"first_name": "GARY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-20",
"last_updated": "2009-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MO",
"license": "2002002061",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RETIRED-PSYCHIATRIST",
"identifier": "193400000X",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GARY",
"last_name": "KULAK",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.