Ursula Gailliot Koeze, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0101057124 Issued in VA

Practice address

459 Locust Ave
MB 26
Charlottesville, VA 22902-4808

Phone

(434) 982-7150

Fax

(434) 982-7147

NPI assigned

Jan 24, 2006

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 identifiers 7

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Emergency Physicians Immediate Care Center 1 PLLC

  • Urgent Care Clinic/Center
  • Midlothian, VA
  • NPI 1598020679
  NPD (past)
• Martha Jefferson Hospital

  • Endoscopy Clinic/Center
  • Charlottesville, VA
  • NPI 1942189022
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1023088960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11647",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321201647",
            "telephone_number": "386-274-7800",
            "fax_number": "386-274-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 LOCUST AVE",
            "address_2": "MB 26",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229024808",
            "telephone_number": "434-982-7150",
            "fax_number": "434-982-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEZE",
        "first_name": "URSULA",
        "middle_name": "GAILLIOT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101057124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29797",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM SVC/HEALTHKEEPERS",
            "identifier": "166192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH",
            "identifier": "29797",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010142890",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "224992",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "930113085",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "P00206926",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily D. Koch, N.P.
• Kristin Rachel Koch, AU. D.
• Sally Haines Koch, FNP-BC
• Shalini Kochicheril
• Emily Koester, RN, CNL
• Valery J Kogler, M.D.
• Lynn R Kohan, MD
• Cory Kohler, MS, RD
• Priya Kohli, M.D.
• Nicole M Koiner, CNM

• Emergency Medicine Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Emergency Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.