GEORGE JACKSON ULLRICH (NPI# 1881788149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881788149 |
| Entity Type | Individual |
| Full Name | GEORGE JACKSON ULLRICH |
| Credential | MD |
| Practice Address |
1115 Ironwood Drive Coeur D Alene ID 83814 |
| Mailing Address |
Po Box 1356 Coeur D Alene ID 83816 |
| Practice Telephone | 2087650955 |
| Practice Fax Number | 2087656972 |
| Mailing Telephone | 2087650955 |
| Mailing Fax Number | 2087656972 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD00031416 | WA | Allopathic & Osteopathic Physicians |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
M6400 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS OF IDAHO | 33852 | 01 |
| MT | MONTANA MEDICAID | 22698 | 01 |
| BLUE CROSS BLUE SHIELD | 000010000418 | 01 |
| Street Address |
1115 IRONWOOD DRIVE |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225284250 | Nathan Trent Taggart | Social Worker | 1115 Ironwood Drive, Coeur D Alene, ID 83814-4936 | 2008-08-11 |
| 1316023567 | Northwest Psychiatric Associates Pa | Psychiatry & Neurology | 1115 Ironwood Drive, Coeur D Alene, ID 83814-4936 | 2006-10-31 |
| 1790861912 | Darlene Elaine Pessein | Social Worker | 1115 Ironwood Drive, Coeur D Alene, ID 83814-4936 | 2006-10-31 |
| 1548357486 | Jami Lynn Sturges | Dietitian, Registered | 1115 Ironwood Drive, Coeur D Alene, ID 83814-4936 | 2006-10-10 |
| 1285728550 | Theresa Ann Kennedy | Social Worker | 1115 Ironwood Drive, Coeur D Alene, ID 83814-4936 | 2006-10-03 |
| 1952495228 | Gary Louis Stanton | Psychologist | 1115 Ironwood Drive, Coeur D Alene, ID 83814-4936 | 2006-10-03 |
| 1356435614 | Ellen Louise Jaeger | Psychologist | 1115 Ironwood Drive, Coeur D Alene, ID 83814-4936 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356500649 | Eagle Crest Life Services Inc | Psychiatry & Neurology | 212 S 11th St Ste 3, Coeur D Alene, ID 83814-4000 | 2008-06-03 |
| 1467528984 | Bruce K Miewald | Psychiatry & Neurology | 2199 Ironwood Center Drive, Coeur D Alene, ID 83814 | 2006-11-27 |
| 1730196056 | Nicole L Carlberg | Psychiatry & Neurology | 2426 N Merritt Creek Loop Ste A, Coeur D Alene, ID 83814-4961 | 2006-08-01 |
| 1194713487 | Coralyn J Alexander | Psychiatry & Neurology | 2199 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 | 2005-10-11 |
| 1891140620 | Neil Dilip Patel | Psychiatry & Neurology | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2016-04-29 |
| 1760893945 | Resilience Psychiatric Medicine | Psychiatry & Neurology | 2426 N Merritt Creek Loop Ste A, Coeur D Alene, ID 83814-4961 | 2014-05-09 |
| 1144664848 | John Michael Thurston | Psychiatry & Neurology | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2013-04-24 |
| 1265750707 | Jennifer Rhodes | Psychiatry & Neurology | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2628 | 2010-05-07 |
| 1124258645 | Jaya Praveen Kumar Penagaluri | Psychiatry & Neurology | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2009-07-17 |
| 1093940074 | Justin Paul Garrett | Psychiatry & Neurology | 2199 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 | 2009-05-20 |
| Find all providers in COEUR D ALENE | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
Please comment or provide details below to improve the information on GEORGE JACKSON ULLRICH.
| 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.