Individual provider Active NPI

Gary A. Dula, NURSE PRACTITIONER

  • Nurse Practitioner
  • Mountain Home, TN
National Provider Identifier
1386667558
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN0000006845 Issued in TN
Practice address
James H. Quillen Veteran's Administration Medical Ctr.
Nursing Home Care Unit
Mountain Home, TN 37684
Phone
(423) 979-2836
Fax
(423) 979-2829
NPI assigned
Jul 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN0000006845 TN Primary

Addresses

Primary practice location

James H. Quillen Veteran's Administration Medical Ctr.
Nursing Home Care Unit
Mountain Home, TN 37684

Mailing address

James H. Quillen Veteran's Administration Medical Ctr.
Nursing Home Care Unit
Mountain Home, TN 37684
Phone (423) 979-2836

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140215000156 TN Order and Referring Only - Nurse Practitioner 2668665019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6845TNMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386667558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "JAMES H. QUILLEN VETERAN'S ADMINISTRATION MEDICAL CTR.",
            "address_2": "NURSING HOME CARE UNIT",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-979-2836",
            "fax_number": "423-979-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JAMES H. QUILLEN VETERAN'S ADMINISTRATION MEDICAL CTR.",
            "address_2": "NURSING HOME CARE UNIT",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-979-2836",
            "fax_number": "423-979-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULA",
        "first_name": "GARY",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000006845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, TN

Sources for this page

Verify at the official NPI Registry.