Active NPI
Dale Kukla, P.T
- Physical Therapist
- N Charleston, SC
National Provider Identifier
1922499755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4916
- Practice address
- 5524 Gallatin LN
N Charleston, SC 29420-6803 - Phone
- (843) 906-7169
- NPI assigned
- Feb 16, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4916 | SC | Primary |
Addresses
Primary practice location
5524 Gallatin LN
N Charleston, SC 29420-6803
Mailing address
5524 Gallatin LN
N Charleston, SC 29420-6803
Phone (843) 906-7169
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Dermatology, LLC | Past | 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.
-
- Dermatology Physician
- Mount Pleasant, SC
- NPI 1164690822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455062400000",
"number": "1922499755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5524 GALLATIN LN",
"city": "N CHARLESTON",
"state": "SC",
"postal_code": "294206803",
"telephone_number": "843-906-7169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5524 GALLATIN LN",
"city": "N CHARLESTON",
"state": "SC",
"postal_code": "294206803",
"telephone_number": "843-906-7169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUKLA",
"first_name": "DALE",
"credential": "P.T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-16",
"last_updated": "2016-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "4916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in N Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.