Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1508952797 Individual Practitioner Male Practitioner

Brian Ullom

Pediatrics • Wapato, WA

Professional Overview & Biography Verified Profile Summary

Brian Ullom is a registered healthcare professional specializing in Pediatrics in Wapato, WA. Practice services are available at 620 W 1ST ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

620 W 1st St

Wapato, WA 989511108

Telephone 5098774111
Fax 5098777349
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Wapato, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.8 Yrs
Regional Practice Density
2 Specialists

Practicing in Wapato, WA (1802 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-03-24
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License WA MD00032635

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
8180184 (WA)
Commercial Insurance / Payer ID Regence
UL4310 (WA)
Commercial Insurance / Payer ID Group Health
6730
Commercial Insurance / Payer ID Commercial
911019392
Commercial Insurance / Payer ID Chpw
8180184 (WA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
NPI 1053517961

Doctor of Medicine (M.D.)

Pamela Smith

Pediatrics

NPI 1073673521
Nargis Mozafari

Psychologist - Clinical

NPI 1194134825
Bonnie Oxford , FNP

Nurse Practitioner

NPI 1366000515

Family Nurse Practitioner

Dr. Roy Gondo , MD

Family Medicine

NPI 1669476131

Doctor of Medicine (M.D.)

Sara Routt , LSWAIC

Social Worker

NPI 1992305288

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location January 22, 2020

Registered at 620 W 1ST ST, WAPATO, WA 989511108 (Tel: 5098774111)

📍
Updated Business Mailing Address January 22, 2020

Registered at 620 W 1ST ST, WAPATO, WA 989511108 (Tel: 5098774111)

👤
Provider Name / Credentials Updated January 22, 2020

Recorded as BRIAN ULLOM

NPI Profile Active December 20, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location December 20, 2012

Registered at 518 W 1ST AVE, TOPPENISH, WA 989481564 (Tel: 5098655600)

📍
Updated Business Mailing Address December 20, 2012

Registered at PO BOX 190, TOPPENISH, WA 989480190 (Tel: 5098656175)

👤
Provider Name / Credentials Updated December 20, 2012

Recorded as BRIAN ULLOM, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 20, 2012

Pediatrics (License #MD00032635 in WA)

🟢
Initial NPI Registration & Enumeration October 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1508952797
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 05, 2006
Last Update: March 24, 2021
Sole Proprietor: No

Mailing Address

620 W 1st St

Wapato, WA 989511108

Phone: 5098774111

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.