Individual provider Active NPI

Katherine Elizabeth Hutchison-Ulloa, D.O.

  • Family Medicine Physician
  • Athens, OH
National Provider Identifier
1699955518
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34-009449 Issued in OH
Practice address
86 Columbus Cir
#203
Athens, OH 45701-1371
Phone
(740) 249-4122
Fax
(740) 249-4126
NPI assigned
Nov 8, 2007
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34-009449 OH Primary

Addresses

Primary practice location

86 Columbus Cir
#203
Athens, OH 45701-1371

Mailing address

5450 Frantz Rd Ste 360
Dublin, OH 43016-4141
Phone (614) 544-6155

Other identifiers 1

IdentifierTypeStateIssuer
3067078MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khutchisooa171338@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100728001269 OH Practitioner - Family Practice 1052444940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

86 Columbus Cir
Suite 203
Athens, OH 45701-1371
Phone (740) 249-4122

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34-009449OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Feb 1, 2020 Accepting new patients
Ohiohealth Corporation Family Medicine CurrentSince Feb 1, 2020 Accepting new patients

Locations

75 Hospital Dr
Ste 310
Athens, OH 45701
Phone (740) 594-6100

86 Columbus Cir
Ste 203
Athens, OH 45701
Phone (740) 249-4081

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

Organizations & group practices 2

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 1

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": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1699955518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164141",
            "telephone_number": "614-544-6155",
            "fax_number": "614-544-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 COLUMBUS CIR",
            "address_2": "#203",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011371",
            "telephone_number": "740-249-4122",
            "fax_number": "740-249-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHISON-ULLOA",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2022-01-25",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-009449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3067078",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khutchisooa171338@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "26 Hospital Dr",
            "address_2": "1st Fl",
            "city": "Athens",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457012471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.