Kristin Michelle Gullen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

296340 Issued in CA

Practice address

750 W Route 66 Ste N
Glendora, CA 91740-4164

Phone

(626) 335-4077

NPI assigned

Feb 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Krissy Michelle Gullen Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evergreen Physical Therapy Specialists IncGroup PAC ID 9537111745, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Evergreen Physical Therapy Specialists, Inc

  • Physical Therapy Clinic/Center
  • Pasadena, CA
  • NPI 1346300670

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Foothill Family Service - Hudson

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pasadena, CA
  • NPI 1336275056
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1922564582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W ROUTE 66 STE N",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W ROUTE 66 STE N",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404164",
            "telephone_number": "626-335-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLEN",
        "first_name": "KRISTIN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISSY",
            "last_name": "GULLEN",
            "middle_name": "MICHELLE",
            "prefix": "MRS.",
            "credential": "DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Audrey Guentert, PTA
• Michelle Grace Reotutar Guerrero
• Haidy Samuel Guirguis, FNP
• Maged Guirguis
• Erik Gullen, PT
• Gunupati V Chelvapilla MD,Medical Corporation
• Gurjeet Kalkat LLC
• Ilana Gustaferro
• James Douglas Gustin, D.C.
• Sheila Garrett Gutierrez, LMFT

• Physical Therapist in Glendora, CA
• Providers in Glendora, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.

Verify at the official NPI Registry.