Ultra Health LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

ULTRA HEALTH LLC

Doing business as

Town Center

Practice address

1107 Riverview St
Grundy, VA 24614-9481

Phone

(267) 385-1186

NPI assigned

Sep 13, 2017

Last updated

Mar 1, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

ULTRA HEALTH LLCAs reported in NPPES

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

Authorized official

Name

Jeffery H Taylor

Title

Member

Phone

(276) 971-0783

Specialties & licenses 1

Addresses

Other names 1

• Town Center Doing business as

Part of

Trina HLTH of Pounding Mill

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Ultra Health LLC

  • Clinic/Center
  • Moneta, VA
  • NPI 1457891145
  NPPES parent name

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.

• Mark Mullins, F.N.P.

  • Family Nurse Practitioner
  • Pounding Mill, VA
  • NPI 1114322955
  NPD

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551398400000",
    "number": "1285153072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 289",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246090289",
            "telephone_number": "276-970-1979",
            "fax_number": "276-258-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 RIVERVIEW ST",
            "city": "GRUNDY",
            "state": "VA",
            "postal_code": "246149481",
            "telephone_number": "267-385-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRA HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ULTRA HEALTH LLC",
        "enumeration_date": "2017-09-13",
        "last_updated": "2019-03-01",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "276-971-0783"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Town Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Virginia Department of Health (Buchanan County Health Department)
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• Endocrinology, Diabetes & Metabolism Physician in Grundy, VA
• Providers in Grundy, VA by specialty
• Endocrinology, Diabetes & Metabolism Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; 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.