Individual provider Active NPI

Jeffrey Wade Gatling, DPT

  • Physical Therapist
  • Kapa'a, HI
National Provider Identifier
1962698225
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2884 Issued in HI
Practice address
4-901 Kuhio Hwy
Ste a
Kapaa, HI 96746-1549
Phone
(808) 826-6000
Fax
(844) 965-9830
NPI assigned
Sep 20, 2007
Last updated
Apr 28, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 33374 CA
Physical Therapist 225100000X 2884 HI Primary

Addresses

Primary practice location

4-901 Kuhio Hwy
Ste a
Kapaa, HI 96746-1549

Mailing address

6300 Helena LN
Kapaa, HI 96746-9107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120329000148 HI Practitioner - Physical Therapist in Private Practice 8820258825 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4-901 Kuhio Hwy
Suite a
Kapaa, HI 96746-1549
Phone (808) 335-5808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2884HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy at Pukalani, LLC Physical Therapist CurrentSince Apr 6, 2021 Accepting new patients
Darrin Huth Inc. Physical Therapist CurrentSince Apr 6, 2021 Accepting new patients
Ohana Sports Medicine Kapaa LLC CurrentSince Feb 1, 2019 Accepting new patients

Locations

4-901 Kuhio Hwy
Ste A
Kapaa, HI 96746
Phone (808) 335-5808

81 Makawao Ave
Ste 110
Makawao, HI 96768
Phone (808) 572-2281

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1962698225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 HELENA LN",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967469107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4-901 KUHIO HWY",
            "address_2": "STE A",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967461549",
            "telephone_number": "808-826-6000",
            "fax_number": "844-965-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATLING",
        "first_name": "JEFFREY",
        "middle_name": "WADE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-20",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33374",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "2884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapa'a, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; 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.