Peter F Ullrich Jr., MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

36628 Issued in WI

Practice address

5320 Michaels Dr
Appleton, WI 54913-8446

Phone

(920) 882-8200

Fax

(920) 882-8210

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1487646691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 MICHAELS DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138446",
            "telephone_number": "920-882-8200",
            "fax_number": "920-882-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 MICHAELS DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138446",
            "telephone_number": "920-882-8200",
            "fax_number": "920-882-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLRICH",
        "first_name": "PETER",
        "middle_name": "F",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "36628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32123400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• United Anesthesia, S.C.

• Surgery Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.