Frederick A Ulam III, PHD, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PYR0452 Issued in MO

Practice address

516 E Catalpa St
Springfield, MO 65807-1614

Phone

(417) 864-8920

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Neuropsychological Associates of Southwest Missouri, P.C.

  • Clinical Neuropsychologist
  • Springfield, MO
  • NPI 1780776807
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1356424972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 E CATALPA ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658071614",
            "telephone_number": "417-864-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E CATALPA ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658071614",
            "telephone_number": "417-864-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULAM",
        "first_name": "FREDERICK",
        "middle_name": "A",
        "name_suffix": "III",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MO",
            "license": "PYR0452",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MO",
            "license": "PYR0452",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MO",
            "license": "PYR0452",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "MO",
            "license": "PYR0452",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "R0452",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "PYR0452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495011611",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00174113",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Felicia R Udovich, MS, PLPC
• Daishi Uekuri
• Joseph D Uhl, LMSW
• Ashley Uhlmann
• David C Ukena, DDS
• Jessica Ulbrich
• Alexander Edmund Underwood, MD
• United Seating and Mobility LLC
• Unity Home Health Services
• Anita Gopal Unnithan, M.D.

• Clinical Psychologist in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.