Individual provider Active NPI

Mary Elizabeth Ulrich, ANP, FNP

  • Family Nurse Practitioner
  • Terre Haute, IN
National Provider Identifier
1588755078
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN966-402 Issued in DC
Practice address
1436 Locust St
St Ann's Clinic/Wabash Valley Health Center
Terre Haute, IN 47807-1648
Phone
(812) 232-7447
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71004290B IN
Family Nurse Practitioner 363LF0000X RN966-402 DC Primary

Addresses

Primary practice location

1436 Locust St
St Ann's Clinic/Wabash Valley Health Center
Terre Haute, IN 47807-1648

Mailing address

Sa-1 State Dept M/Med/Qi
2401 E Street NW
Washington, DC 20522-0001
Phone (202) 663-1647

Other names 1

  • Mrs. Mary Elizabeth Braun Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141202001222 IN Practitioner - Nurse Practitioner 9032431028 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71004290BINMDAdult Health Nurse Practitioner
RN966-402DCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Intervention and Education Foundation Incorporated CurrentSince Dec 10, 2018 Accepting new patients

Locations

109 S Jefferson St
Rockville, IN 47872
Phone (765) 569-4008

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1588755078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SA-1 STATE DEPT M/MED/QI",
            "address_2": "2401 E STREET NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "205220001",
            "telephone_number": "202-663-1647",
            "fax_number": "202-663-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 LOCUST ST",
            "address_2": "ST ANN'S CLINIC/WABASH VALLEY HEALTH CENTER",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478071648",
            "telephone_number": "812-232-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULRICH",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "ANP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71004290B",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN966-402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BRAUN",
            "middle_name": "ELIZABETH",
            "prefix": "MRS.",
            "credential": "ANP, FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.