Individual provider Active NPI

Barry Ulm

  • Pharmacist
  • Springfield, IL
National Provider Identifier
1174845192
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0510322766 Issued in IL
Practice address
2500 Wabash Ave
Springfield, IL 62704-4203
Phone
(217) 787-0434
NPI assigned
Feb 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0510322766 IL Primary

Addresses

Primary practice location

2500 Wabash Ave
Springfield, IL 62704-4203

Mailing address

2500 Wabash Ave
Springfield, IL 62704-4203
Phone (217) 787-0434

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0510322766ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1174845192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 WABASH AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044203",
            "telephone_number": "217-787-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 WABASH AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044203",
            "telephone_number": "217-787-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULM",
        "first_name": "BARRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "0510322766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.