Individual provider Active NPI

Kenneth A Ullrich, AUD MS

  • Audiologist
  • Wenatchee, WA
National Provider Identifier
1285616482
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
D00001397 Issued in WA
Practice address
933 Red Apple Rd
Ste 100
Wenatchee, WA 98801-3370
Phone
(509) 662-7143
Fax
(509) 665-4301
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X D00001397 WA Primary
Audiologist-Hearing Aid Fitter 237600000X

Addresses

Primary practice location

933 Red Apple Rd
Ste 100
Wenatchee, WA 98801-3370

Mailing address

PO Box 3027
Wenatchee, WA 98807-3027
Phone (509) 662-7143

Other identifiers 1

IdentifierTypeStateIssuer
1043553MedicaidWA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D00001397WAMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1285616482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3027",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988073027",
            "telephone_number": "509-662-7143",
            "fax_number": "509-665-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 RED APPLE RD",
            "address_2": "STE 100",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013370",
            "telephone_number": "509-662-7143",
            "fax_number": "509-665-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLRICH",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "AUD MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "D00001397",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043553",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; 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.