Individual provider Active NPI

Jeffery Gulch, P.T.

  • Physical Therapist
  • Toledo, OH
National Provider Identifier
1982749800
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-07895 Issued in OH
Practice address
2865 N Reynolds Rd Ste 110
Toledo, OH 43615-2069
Phone
(419) 578-7530
Fax
(419) 539-0288
NPI assigned
Feb 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-07895 OH Primary

Addresses

Primary practice location

2865 N Reynolds Rd Ste 110
Toledo, OH 43615-2069

Mailing address

110 Hidden Meadow Dr
Holland, OH 43528-8277

Other identifiers 1

IdentifierTypeStateIssuer
000000300948OtherOHANTHEM PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160513001359 OH Practitioner - Physical Therapist in Private Practice 0648569616 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-07895OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fostoria Hospital Association Physical Therapist CurrentSince Nov 1, 2015 Accepting new patients
Fostoria Hospital Association CurrentSince Nov 1, 2015 Accepting new patients
The Toledo Hospital Past Accepting new patients
Reynolds Road Fitness Center Inc. Past Accepting new patients

Locations

1180 N Main St
Bowling Green, OH 43402
Phone (419) 315-1225

455 W 4th St
Ste 10
Fostoria, OH 44830
Phone (419) 436-8320

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982749800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HIDDEN MEADOW DR",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435288277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 N REYNOLDS RD STE 110",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152069",
            "telephone_number": "419-578-7530",
            "fax_number": "419-539-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULCH",
        "first_name": "JEFFERY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT-07895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000300948",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.