Active NPI
Thomas H Gulley, OD
- Optometrist
- Little Rock, AR
National Provider Identifier
1811995368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2075
- Practice address
- 404 Louisiana St
Little Rock, AR 72201-3702 - Phone
- (501) 375-8271
- Fax
- (501) 375-8272
- NPI assigned
- Jul 8, 2005
- Last updated
- Jul 1, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vision Therapy Optometrist | 152WV0400X | 2075 | AR | |
| Optometrist | 152W00000X | 2075 | AR | Primary |
Addresses
Primary practice location
404 Louisiana St
Little Rock, AR 72201-3702
Mailing address
404 Louisiana St
Little Rock, AR 72201-3702
Phone (501) 375-8271
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0436770001 | Other | AR | PALMETTO |
| 104316722 | Medicaid | AR | |
| 2220008 | Other | AR | UNITED HEALTHCARE |
| 17371000040 | Other | AR | QUAL CHOICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1811995368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 LOUISIANA ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722013702",
"telephone_number": "501-375-8271",
"fax_number": "501-375-8272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 LOUISIANA ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722013702",
"telephone_number": "501-375-8271",
"fax_number": "501-375-8272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULLEY",
"first_name": "THOMAS",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-08",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "AR",
"license": "2075",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AR",
"license": "2075",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO",
"identifier": "0436770001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104316722",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2220008",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUAL CHOICE",
"identifier": "17371000040",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.