Active NPI
Eric Alan Gully, P.T.
- Physical Therapist
- Wailuku, HI
National Provider Identifier
1154560480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2010
- Practice address
- 6 Central Ave
Wailuku, HI 96793-1703 - Phone
- (808) 244-5541
- NPI assigned
- Feb 10, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2010 | HI | Primary |
Addresses
Primary practice location
6 Central Ave
Wailuku, HI 96793-1703
Mailing address
909 Delrey Dr
College Station, TX 77845-5091
Phone (979) 777-5669
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010 | HI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Physical Therapy and Sports | Physical Therapist | Past | Accepting new patients |
| Community Clinic of Maui, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Kahului, HI
- NPI 1467346916
-
- Physical Therapist
- Makawao, HI
- NPI 1235180811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234224000000",
"number": "1154560480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 DELREY DR",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778455091",
"telephone_number": "979-777-5669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 CENTRAL AVE",
"city": "WAILUKU",
"state": "HI",
"postal_code": "967931703",
"telephone_number": "808-244-5541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULLY",
"first_name": "ERIC",
"middle_name": "ALAN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-10",
"last_updated": "2009-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "HI",
"license": "2010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wailuku, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.