Individual provider Active NPI

Kaleigh Gangi Bull, PT, DPT

  • Pediatric Physical Therapist
  • Kailua, HI
National Provider Identifier
1861266785
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT-5804 Issued in HI
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

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20240209001031 HI Practitioner - Physical Therapist in Private Practice 4284077967 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0017761COMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Three Little Ducks Pediatrics CurrentSince Jan 22, 2024 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.

Verify at the official NPI Registry.