DR. GARY MICHAEL ULLERY D.O. NPI 1164785382

NPI Information

  • NPI: 1164785382
  • Provider Name: DR. GARY MICHAEL ULLERY, D.O.
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 98 POPLAR ST FL 2
    BLACKFOOT, ID
    ZIP 83221
  • Phone: (208) 782-2380

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NPI Details

DR. Gary Michael Ullery, D.O. is an internal medicine in Blackfoot, ID with 14 years of experience. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. DR. Gary Michael Ullery, D.O. NPI is 1164785382. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

98 POPLAR ST FL 2
BLACKFOOT, ID
ZIP 83221-758
Phone: (208) 782-2380
Fax: (208) 785-3504

The NPI 1164785382 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/21/2012 and was last updated on 1/3/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineO-0906IDAHOYes
2208000000XPediatricsO-0906IDAHONo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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