Individual provider Active NPI

Gabriel A Cullom

  • Taxi
  • Des Moines, IA
National Provider Identifier
1508126871
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
TaxiTaxonomy code 344600000X
License
3343 Issued in IA
Practice address
2328 E 40TH St
Des Moines, IA 50317-5624
Phone
(515) 422-0606
NPI assigned
May 21, 2012
Last updated
May 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Taxi 344600000X 3343 IA Primary

Addresses

Primary practice location

2328 E 40TH St
Des Moines, IA 50317-5624

Mailing address

2328 E 40TH St
Des Moines, IA 50317-5624
Phone (515) 422-0606

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

LicenseStateTypeSpecialty
3343IAMDTaxi

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1508126871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 E 40TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503175624",
            "telephone_number": "515-422-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2328 E 40TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503175624",
            "telephone_number": "515-422-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLOM",
        "first_name": "GABRIEL",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "344600000X",
            "taxonomy_group": "",
            "desc": "Taxi",
            "state": "IA",
            "license": "3343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.