CHARLES DEAN ULRICH II (NPI# 1790741080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790741080 |
| Entity Type | Individual |
| Full Name | CHARLES DEAN ULRICH II |
| Credential | MD |
| Practice Address |
101 Willmar Ave Sw Affiliated Community Medical Centers Willmar MN 56201 |
| Practice Telephone | 3202315000 |
| Practice Fax Number | 3202315067 |
| Mailing Telephone | 3202315000 |
| Mailing Fax Number | 3202315067 |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2008-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
33912 | MN | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
H4760 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 166460901 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992051163 | Charles Henry Ulrich | General Practice | 110-00 Rockaway Blvd., The New York Racing Association, Inc, Jamaica, NY 11417 | 2012-07-25 |
| Street Address |
101 WILLMAR AVE SW AFFILIATED COMMUNITY MEDICAL CENTERS |
| City | WILLMAR |
| State | MN |
| Zip Code | 56201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922004514 | Gregory M Macik | Optometrist | 101 Willmar Ave Sw, Affiliated Community Medical Centers, Willmar, MN 56201 | 2005-06-28 |
| 1356956601 | Crystal Lynn Fleischhacker | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-09-14 |
| 1730798760 | Katherine Anderson | Pharmacist | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-07-27 |
| 1861015786 | Madalyn Marie Vohnoutka | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-05-27 |
| 1811526403 | Meagan A Hoflock | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-04-06 |
| 1124657150 | Carris Health LLC | Clinic/Center | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-04-02 |
| 1689209900 | Sophie Sharon Reecher | Physician Assistant | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-03-06 |
| 1285267922 | Kavitha Malango | Nurse Practitioner | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2020-02-21 |
| 1972147858 | Jamie Kalean Erickson | Pharmacist | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2019-11-04 |
| 1124660865 | Carris Health LLC | Durable Medical Equipment & Medical Supplies | 101 Willmar Ave Sw, Willmar, MN 56201-3556 | 2019-10-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730793472 | Sarah Erickson | Counselor | 2120 60th Ave N.w., Willmar, MN 56201 | 2020-09-01 |
| 1417560681 | Amy Engle | Nurse Practitioner | 1125 Se 8th Street, Willmar, MN 56201 | 2020-08-28 |
| 1154856524 | Mude Transportation Inc | Non-emergency Medical Transport (VAN) | 1712 Monongalia Ave Sw Ap1, Willmar, MN 56201 | 2017-04-24 |
| 1285025874 | Jill Fellows | Occupational Therapist | 611 5th St. Sw, Willmar, MN 56201 | 2015-02-18 |
| 1700294881 | Brenda Wiese | Counselor | 1617 Hwy 12 E, Suite 230, Willmar, MN 56201 | 2014-08-01 |
| 1275955932 | Courtney Regnier | Marriage & Family Therapist | 2320 E Hwy 12 Ste 2, Willmar, MN 56201 | 2014-01-15 |
| 1568732402 | Pamela Jean Kubesh | Social Worker | 328 Sw 3rd Street, Willmar, MN 56201 | 2012-01-10 |
| 1699931824 | Community Behavioral Health Hospital-willmar | Psychiatric Hospital | 1208 Olena Ave Se, Willmar, MN 56201 | 2008-08-07 |
| 1700053345 | Nathan Schrick | Marriage & Family Therapist | 513 Sw 5th Street, Box 1810, Willmar, MN 56201 | 2008-05-13 |
| 1831381680 | Joan M Blonigan Christianson | Chiropractor | 1101 S 1st Street, Willmar, MN 56201 | 2007-08-15 |
| Find all providers in zip 56201 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457795775 | Tyson Sievers | Internal Medicine | 406 Harvard St Se, Mmc 36, Minneapolis, MN 55455-0362 | 2013-04-18 |
| 1114269461 | Sachin Mohan | Internal Medicine | 640 Jackson St # Mc11503f, Saint Paul, MN 55101-2502 | 2013-03-25 |
| 1609011949 | Elizabeth Fallon | Internal Medicine | 2550 University Ave West Suite 423 South, Minneapolis, MN 55114-1904 | 2008-12-15 |
| 1780829440 | Albert Dallas Newcomer | Internal Medicine | 437 Eagle Ln Sw, Rochester, MN 55902-4137 | 2008-12-10 |
| 1528215415 | Ronald F Kettering | Internal Medicine | 1635 11th Ave Ne, Rochester, MN 55906-4266 | 2008-08-21 |
| 1710147392 | Ridgeview Clinics | Internal Medicine | 560 South Maple Street, Suite 220, Waconia, MN 55387-0000 | 2008-06-17 |
| 1265609085 | Jeffrey Sanders | Internal Medicine | 1185 Town Centre Dr #205, Eagan, MN 55123-1343 | 2008-05-12 |
| 1467640482 | Metropolitan Gastrointestinal Specialists | Internal Medicine | 17322 91st Ave N, Maple Grove, MN 55311-5403 | 2007-10-04 |
| 1144412503 | Paul R Dambowy | Internal Medicine | 1973 Sloan Pl Ste 100, Saint Paul, MN 55117-2085 | 2007-08-09 |
| 1598962656 | Maria E Moscandrew | Internal Medicine | 825 S 8th St Ste 250, Minneapolis, MN 55404-1214 | 2007-06-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.