NPIMap

Individual provider Active NPI

Michael Alan Ulrich, DO

  • Internal Medicine Physician
  • Abingdon, VA
National Provider Identifier
1730179706
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102049979 Issued in VA
Practice address
16000 Johnston Memorial Dr
Fourth Floor
Abingdon, VA 24211-7664
Phone
(276) 258-4050
Fax
(276) 258-4056
NPI assigned
Oct 21, 2005
Last updated
Feb 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102049979 VA Primary

Addresses

Primary practice location

16000 Johnston Memorial Dr
Fourth Floor
Abingdon, VA 24211-7664

Mailing address

16000 Johnston Memorial Dr
Fourth Floor
Abingdon, VA 24211-7664
Phone (276) 258-4050

Other identifiers 3

IdentifierTypeStateIssuer
1525574MedicaidTN
1730179706MedicaidVA
P01063117OtherVARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090930000058 VA Practitioner - Internal Medicine 8426015116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Charles Health Council IncGroup PAC ID 0244124584, shared by 12 NPIs, 10 clinicians

Practice addresses (Care Compare)

20471 Azen Rd
Damascus, VA 24236-4141
Phone (276) 388-3411

276 Fieldstone Dr
Jonesville, VA 24263-1215
Phone (276) 546-3001

306 S Shady Ave
Damascus, VA 24236
Phone (276) 475-5116

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102049979VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Aug 15, 2009 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Aug 15, 2009 Accepting new patients
Blue Ridge Medical Management Corporation Internal Medicine Past Accepting new patients
St. Charles Health Council, Inc Past Accepting new patients

Locations

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

1205 Snider St
#B
Marion, VA 24354
Phone (276) 258-1777

Organizations & group practices 5

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 3

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1730179706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 JOHNSTON MEMORIAL DR",
            "address_2": "FOURTH FLOOR",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117664",
            "telephone_number": "276-258-4050",
            "fax_number": "276-258-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 JOHNSTON MEMORIAL DR",
            "address_2": "FOURTH FLOOR",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117664",
            "telephone_number": "276-258-4050",
            "fax_number": "276-258-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULRICH",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102049979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525574",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730179706",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01063117",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

Verify at the official NPI Registry.