Ulysees Gammage Jr

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

6000005706 Issued in PA

Legal business name

ULYSEES GAMMAGE JR

Doing business as

Universale Pedorthic Services

Practice address

6037 Castor Ave
Philadelphia, PA 19149-3207

Phone

(215) 776-0981

Fax

(215) 224-6611

NPI assigned

Mar 27, 2007

Last updated

Aug 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ulysees Gammage Jr.

Title

Owner

Phone

(215) 776-0981

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Universale Pedorthic Services Doing business as

Locations

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1679691711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6037 CASTOR AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191493207",
            "telephone_number": "215-776-0981",
            "fax_number": "215-224-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6037 CASTOR AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191493207",
            "telephone_number": "215-776-0981",
            "fax_number": "215-224-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULYSEES GAMMAGE JR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "GAMMAGE",
        "authorized_official_first_name": "ULYSEES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-776-0981",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "PA",
            "license": "6000005706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE EAST",
            "identifier": "0005113000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE",
            "identifier": "0005113000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DURABLE MEDICAL EQUIPTMEN",
            "identifier": "0005113000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Universale Pedorthic Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Customized Equipment (DME) in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Customized Equipment (DME) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.