Joel E Ulloth, MD Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A108943 Issued in CA

Legal business name

JOEL E ULLOTH, MD INC.

Practice address

85 Maui Lani Pkwy
Wailuku, HI 96793-2416

Phone

(808) 442-5700

Fax

(808) 442-5701

NPI assigned

Aug 6, 2009

Last updated

Feb 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joel E Ulloth, M.D.NPI 1932159886

Title

President

Phone

(530) 276-7352

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Practitioners 1

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.

• Joel Elden Ulloth, MD

  • Surgery Physician
  • Mailuku, HI
  • NPI 1932159886
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549238400000",
    "number": "1255562302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496084",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496084",
            "telephone_number": "530-241-9800",
            "fax_number": "530-241-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 MAUI LANI PKWY",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932416",
            "telephone_number": "808-442-5700",
            "fax_number": "808-442-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL E ULLOTH, MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2019-02-04",
        "status": "A",
        "authorized_official_last_name": "ULLOTH",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-276-7352",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A108943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255562302",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey M Drood MD LLC
• Leda Jellum, DPT
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• Kirsten Marie Jensen, NP
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• Kazue T Johansen, P.A.
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• Aimee Lynn Johnson, DPT
• Jaimie Mariko Johnson, M.D.
• Jon Betwee M D LTD

• Specialist in Wailuku, HI
• Providers in Wailuku, HI by specialty
• Specialist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.