Individual provider Active NPI

Jason T Gulley, DPT

  • Physical Therapist
  • Sisters, OR
National Provider Identifier
1700928330
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
60154 Issued in OR
Practice address
325 N Locust St
Sisters, OR 97759-5047
Phone
(828) 966-9036
Fax
(828) 966-4538
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gregory Zadow Inc PS 7 clinicians

Practice addresses (Care Compare)

325 N Locust St
Sisters, OR 97759-5047
Phone (541) 549-3534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, NC2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20130529000605 OR Practitioner - Physical Therapist in Private Practice 8921027459 Reassigns benefits to 1 organization
I20170320001691 NC Practitioner - Physical Therapist in Private Practice 8921027459 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60154ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Black Mountain Physical Therapy, LLC Physical Therapist CurrentSince Apr 10, 2017 Accepting new patients
Gregory Zadow Inc. P.S. Physical Therapist CurrentSince Apr 22, 2019 Accepting new patients
Care Medical Group, Inc. P.S. Past Accepting new patients

Locations

997 Old US Hwy 70 W
Ste D
Black Mtn, NC 28711
Phone (828) 669-6896

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 16796 NC
Physical Therapist 225100000X 60154 OR Primary

Addresses

NPPES NPI Registry

Primary practice location

325 N Locust St
Sisters, OR 97759-5047

Mailing address

PO Box 1911
Sisters, OR 97759-1911
Phone (541) 299-0294

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2023.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1700928330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1911",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977591911",
            "telephone_number": "541-299-0294",
            "fax_number": "541-549-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N LOCUST ST",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977595047",
            "telephone_number": "828-966-9036",
            "fax_number": "828-966-4538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLEY",
        "first_name": "JASON",
        "middle_name": "T",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "16796",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sisters, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.