NPIMap

Individual provider Active NPI

Russell Dean Ulrich, DO

  • Geriatric Medicine (Family Medicine) Physician
  • Piedmont, AL
National Provider Identifier
1407850126
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
DO 47 Issued in AL
Practice address
25 Roundtree Dr
Piedmont, AL 36272-5893
Phone
(256) 447-9045
Fax
(256) 447-9040
NPI assigned
Jun 9, 2005
Last updated
Jan 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X DO 47 AL Primary

Addresses

Primary practice location

25 Roundtree Dr
Piedmont, AL 36272-5893

Mailing address

25 Roundtree Dr
Piedmont, AL 36272-5893
Phone (256) 447-9045

Other identifiers 2

IdentifierTypeStateIssuer
000010742MedicaidAL
510-10742OtherALBLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address russellulrich@piedmontfpc.direct.emds.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080513000396 AL Practitioner - Family PracticePractitioner - Geriatric Medicine 8224107552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Family Practice Center PCGroup PAC ID 1153490487, 2 clinicians

Practice addresses (Care Compare)

25 Roundtree Dr
Piedmont, AL 36272-5893
Phone (256) 447-9045

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO 47ALMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Family Practice Center PC Geriatric Medicine CurrentSince Apr 2, 1993 Accepting new patients
Self-Recovery, LLC Past Accepting new patients
Piedmont Health Care Center Past Accepting new patients

Locations

25 Roundtree Dr
Piedmont, AL 36272
Phone (256) 447-9045

800 Memorial Dr
Piedmont, AL 36272
Phone (256) 447-9045

Networks

  • bcbs alabama network 01H0
  • bcbs alabama network 01C0
  • bcbs alabama network 01E0
  • bcbs alabama network 01A0
  • bcbs alabama network 01B0
  • bcbs alabama network 01G0

Interoperability endpoints

  • Direct secure messaging: rulrich@pfpc.ssdirect.aprima.com

Organizations & group practices 3

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

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1407850126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ROUNDTREE DR",
            "city": "PIEDMONT",
            "state": "AL",
            "postal_code": "362725893",
            "telephone_number": "256-447-9045",
            "fax_number": "256-447-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ROUNDTREE DR",
            "city": "PIEDMONT",
            "state": "AL",
            "postal_code": "362725893",
            "telephone_number": "256-447-9045",
            "fax_number": "256-447-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULRICH",
        "first_name": "RUSSELL",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "DO 47",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000010742",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "510-10742",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "russellulrich@piedmontfpc.direct.emds.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "25 Roundtree Dr",
            "city": "Piedmont",
            "state": "AL",
            "country_code": "US",
            "postal_code": "362725893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Piedmont, AL

Sources for this page

Verify at the official NPI Registry.