Benjamin Tabiolo Ulep, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

0101840437 Issued in VA

Practice address

Sussex II State Prison
24427 Musselwhite Dr
Waverly, VA 23891-0001

Phone

(804) 834-2678

Fax

(804) 834-2600

NPI assigned

Apr 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992923825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12705 KARLYN CT",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238362553",
            "telephone_number": "804-530-0906",
            "fax_number": "804-834-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUSSEX II STATE PRISON",
            "address_2": "24427 MUSSELWHITE DR",
            "city": "WAVERLY",
            "state": "VA",
            "postal_code": "238910001",
            "telephone_number": "804-834-2678",
            "fax_number": "804-834-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULEP",
        "first_name": "BENJAMIN",
        "middle_name": "TABIOLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101840437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providing Ease Residential Services
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• Waverly Pharmacy LLC
• Waverly Rescue Squad, Inc
• Waverly VA Opco LLC (Accordius Health at Waverly)
• Waverly Volunteer Rescue Squad

• General Practice Physician in Waverly, VA
• Providers in Waverly, VA by specialty
• General Practice Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.