Individual provider Active NPI

Elizabeth Colleen Ullrich, DO

  • Hospitalist Physician
  • Fishersville, VA
National Provider Identifier
1912403767
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
0102206572 Issued in VA
Practice address
78 Medical Center Dr
Fishersville, VA 22939-2332
Phone
(540) 332-4444
NPI assigned
Apr 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102206572 VA
Internal Medicine Physician 207R00000X 0116031960 VA
Internal Medicine Physician 207R00000X VA0116031960 VA
Hospitalist Physician 208M00000X 0102206572 VA Primary

Addresses

Primary practice location

78 Medical Center Dr
Fishersville, VA 22939-2332

Mailing address

PO Box 388
Fishersville, VA 22939-0388
Phone (540) 332-4075

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210830000205 VA Practitioner - Hospitalist 8820405749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Augusta Medical GroupGroup PAC ID 3678632544, 409 clinicians

Practice addresses (Care Compare)

78 Medical Ctr Dr
Fishersville, VA 22939-2332
Phone (540) 245-7080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
VA0116031960VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Medical Group CurrentSince Aug 30, 2021 Accepting new patients
Augusta Medical Group CurrentSince Aug 30, 2021 Accepting new patients

Locations

53 S Medical Park Dr
Fishersville, VA 22939
Phone (540) 332-5687

78 Medical Center Dr
Fishersville, VA 22939
Phone (540) 245-7216

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14718/brand/4/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1912403767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388",
            "telephone_number": "540-332-4075",
            "fax_number": "540-932-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 MEDICAL CENTER DR",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392332",
            "telephone_number": "540-332-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLRICH",
        "first_name": "ELIZABETH",
        "middle_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102206572",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0116031960",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "VA0116031960",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0102206572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.