Active NPI
Kaleigh Gangi Bull, PT, DPT
- Pediatric Physical Therapist
- Kailua, HI
National Provider Identifier
1861266785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT-5804
- Practice address
- 644 Keolu Dr
Kailua, HI 96734-3928 - Phone
- (808) 940-2051
- NPI assigned
- Nov 10, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT-5804 | HI | Primary |
| Pediatric Physical Therapist | 2251P0200X | PTL.0017761 | CO |
Addresses
Primary practice location
644 Keolu Dr
Kailua, HI 96734-3928
Mailing address
645 Viridian Dr Apt 266
Lafayette, CO 80026-7049
Other practice location 1
2851 S Parker Rd Ste 1136
Aurora, CO 80014-2732
Phone (720) 465-5754
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL.0017761 | CO | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Three Little Ducks | Pediatrics | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699574400000",
"number": "1861266785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "645 VIRIDIAN DR APT 266",
"city": "LAFAYETTE",
"state": "CO",
"postal_code": "800267049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "644 KEOLU DR",
"city": "KAILUA",
"state": "HI",
"postal_code": "967343928",
"telephone_number": "808-940-2051"
}
],
"practiceLocations": [
{
"address_1": "2851 S Parker Rd Ste 1136",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "CO",
"postal_code": "800142732",
"country_code": "US",
"telephone_number": "720-465-5754",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BULL",
"first_name": "KALEIGH",
"middle_name": "GANGI",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-11-10",
"last_updated": "2023-11-10",
"certification_date": "2023-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "HI",
"license": "PT-5804",
"primary": true
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CO",
"license": "PTL.0017761",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.