Organization Active NPI

Ulrich Medical Clinic

  • Family Medicine Physician
  • East Bernstadt, KY
National Provider Identifier
1184290645
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ULRICH MEDICAL CLINIC
Practice address
1655 E Highway 3094
East Bernstadt, KY 40729-6216
Phone
(606) 843-2339
Fax
(606) 843-6815
NPI assigned
Jun 3, 2021
Last updated
Jun 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Authorized official

Name
Dennis UlrichNPI 1063413581
Title
Owner
Phone
(606) 843-2339

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1655 E Highway 3094
East Bernstadt, KY 40729-6216

Mailing address

1655 E Highway 3094
East Bernstadt, KY 40729-6216
Phone (606) 843-2339

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210825004009 KY Part B Supplier - Clinic/Group Practice 6507261757 Receives reassigned benefits from 3 practitioners
Practice locations: East Bernstadt, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1184290645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 E HIGHWAY 3094",
            "city": "EAST BERNSTADT",
            "state": "KY",
            "postal_code": "407296216",
            "telephone_number": "606-843-2339",
            "fax_number": "606-843-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 E HIGHWAY 3094",
            "city": "EAST BERNSTADT",
            "state": "KY",
            "postal_code": "407296216",
            "telephone_number": "606-843-2339",
            "fax_number": "606-843-6815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULRICH MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "ULRICH",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-843-2339"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Bernstadt, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.