Individual provider Active NPI

Greogry J. Gulso, DPM

  • Podiatrist
  • Bountiful, UT
National Provider Identifier
1316025323
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
295236-0501 Issued in UT
Practice address
415 Medical Dr Ste C200
Bountiful, UT 84010-4973
Phone
(801) 294-8266
Fax
(801) 294-8265
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 295236-0501 UT Primary

Addresses

Primary practice location

415 Medical Dr Ste C200
Bountiful, UT 84010-4973

Mailing address

415 Medical Dr Ste C200
Bountiful, UT 84010-4973
Phone (801) 294-8266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050914000488 UT Practitioner - Podiatry 5890728455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David H Warby DPMGroup PAC ID 6002829637, 2 clinicians

Practice addresses (Care Compare)

2950 N Church St
Suite 303
Layton, UT 84040-6590
Phone (801) 544-9441

415 Medical Dr
Suite C200
Bountiful, UT 84010-4973
Phone (801) 294-8266

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1342
Removal or shaving of skin growth134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
295236-0501UTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulso Podiatry, LLC CurrentSince Sep 1, 2005 Accepting new patients
David H Warby DPM Podiatrist CurrentSince Feb 7, 2017 Accepting new patients

Locations

415 Medical Dr
Ste C200
Bountiful, UT 84010
Phone (801) 294-8266

2950 N Church St
Ste 303
Layton, UT 84040
Phone (801) 544-9440

Interoperability endpoints

  • Direct secure messaging: gulsopodiatryllc.gulsogregoryj@145060.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1316025323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE C200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104973",
            "telephone_number": "801-294-8266",
            "fax_number": "801-294-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE C200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104973",
            "telephone_number": "801-294-8266",
            "fax_number": "801-294-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULSO",
        "first_name": "GREOGRY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "295236-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.