Individual provider Active NPI

Corey Dietrich Ulrich, PT, MSPT

  • Physical Therapist
  • Arlington, TX
National Provider Identifier
1073681227
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1125342 Issued in TX
Practice address
400 W Arbrook Blvd
Suite 151
Arlington, TX 76014-3181
Phone
(817) 472-8383
Fax
(817) 472-8386
NPI assigned
Dec 4, 2006
Last updated
Jul 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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 1125342 TX Primary

Addresses

Primary practice location

400 W Arbrook Blvd
Suite 151
Arlington, TX 76014-3181

Mailing address

966 N Garden Ridge Blvd
Suite 530
Lewisville, TX 75077-2876
Phone (972) 420-6605

Other identifiers 3

IdentifierTypeStateIssuer
2844359-01MedicaidTX
81646TOtherTXBCBS ID
1125342OtherTXPHYSICAL THERAPIST - REGULAR LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080506000583 TX Practitioner - Physical Therapist in Private Practice 8527147289 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Lewisville Therapy Center Inc Physical Therapist CurrentSince Feb 1, 2008 Accepting new patients
Greater Lewisville Therapy Center Inc Physical Therapist CurrentSince Feb 1, 2008 Accepting new patients

Locations

400 W Arbrook Blvd
Ste 151
Arlington, TX 76014
Phone (817) 472-8383

3733 N Josey Ln
Ste 100
Carrollton, TX 75007
Phone (972) 395-7445

966 N Garden Ridge Blvd
Ste 530
Lewisville, TX 75077
Phone (972) 420-6605

1010 N Belt Line Rd
Ste 102
Mesquite, TX 75149
Phone (972) 288-2400

Organizations & group practices 2

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1073681227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 N GARDEN RIDGE BLVD",
            "address_2": "SUITE 530",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750772876",
            "telephone_number": "972-420-6605",
            "fax_number": "972-436-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W ARBROOK BLVD",
            "address_2": "SUITE 151",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760143181",
            "telephone_number": "817-472-8383",
            "fax_number": "817-472-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULRICH",
        "first_name": "COREY",
        "middle_name": "DIETRICH",
        "name_prefix": "Ms.",
        "credential": "PT, MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1125342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2844359-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "81646T",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST - REGULAR LICENSE",
            "identifier": "1125342",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.