Active NPI
Jason T Gulley, DPT
- Physical Therapist
- Sisters, OR
National Provider Identifier
1700928330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 60154
- 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.
-
- Physical Therapist
- Black Mountain, NC
- NPI 1457696361
NC, Physical Therapist
-
- Family Medicine Physician
- Bellingham, WA
- NPI 1346261500
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
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, NC
Medicare enrollment records 2
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 60154 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Black Mountain Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
| Gregory Zadow Inc. P.S. | Physical Therapist | Current | 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 16796 | NC | |
| Physical Therapist | 225100000X | 60154 | OR | Primary |
Addresses
NPPES NPI RegistryPrimary 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.