Active NPI
Joseph Ian Ulloa
- Pediatric Occupational Therapist
- Clinton, IA
National Provider Identifier
1104858547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 01519
- Practice address
- 1377 11TH St NW
Clinton, IA 52732-5068 - Phone
- (563) 241-4230
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 01519 | IA | Primary |
Addresses
Primary practice location
1377 11TH St NW
Clinton, IA 52732-5068
Mailing address
12018 290TH St
Donahue, IA 52746-9783
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01519 | IA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104858547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12018 290TH ST",
"city": "DONAHUE",
"state": "IA",
"postal_code": "527469783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1377 11TH ST NW",
"city": "CLINTON",
"state": "IA",
"postal_code": "527325068",
"telephone_number": "563-241-4230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ULLOA",
"first_name": "JOSEPH",
"middle_name": "IAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "IA",
"license": "01519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, IA
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.