Active NPI
Gary A. Dula, NURSE PRACTITIONER
- Nurse Practitioner
- Mountain Home, TN
National Provider Identifier
1386667558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APN0000006845
- 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, 2007
- 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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140215000156 | TN | Order and Referring Only - Nurse Practitioner | 2668665019 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6845 | TN | MD | Physician 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.