Individual provider Active NPI

Jennifer Lynn Ulliman, FNP-C

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1083268528
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3016018 Issued in KY
Practice address
3939 7TH Street Rd
Louisville, KY 40216-4103
Phone
(502) 883-6800
Fax
(502) 384-2316
NPI assigned
Aug 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71011206A IN
Family Nurse Practitioner 363LF0000X 3016018 KY Primary
Gerontology Nurse Practitioner 363LG0600X AP142506 TX

Addresses

Primary practice location

3939 7TH Street Rd
Louisville, KY 40216-4103

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 628-6117

Other practice location 1

1640 Fairway
Kyle, TX 78640-8791
Phone (512) 268-1003

Other practice location 2

2100 N Main St Ste 304
Crown Point, IN 46307-1877
Phone (574) 546-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190904002496 TX Practitioner - Nurse Practitioner 5395074140 Reassigns benefits to 1 organization
I20210702002071 KY Practitioner - Nurse Practitioner 5395074140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 W Jefferson St
Louisville, KY 40202-2881

Merit-based Incentive Payment System (MIPS)

Final score
93.06 of 100Reported as group
Quality
80.07
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Ky Holding, LLC CurrentSince Nov 1, 2025 Accepting new patients
Austin Geriatric Specialists, PLLC CurrentSince Jul 30, 2019 Accepting new patients
Hni Medical Services PastSince Jul 30, 2019 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

3939 7th Street Rd
Louisville, KY 40216
Phone (502) 775-1211

2406 W Broadway
Louisville, KY 40211
Phone (502) 775-1211

1108 Lavaca St
Ste 110320
Austin, TX 78701
Phone (512) 482-0390

11406 Rustic Rock Dr
Austin, TX 78750
Phone (512) 251-3915

1640 Fairway
Niederwald, TX 78640
Phone (501) 922-2000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1083268528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117",
            "fax_number": "305-393-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 7TH STREET RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164103",
            "telephone_number": "502-883-6800",
            "fax_number": "502-384-2316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1640 Fairway",
            "address_purpose": "LOCATION",
            "city": "Kyle",
            "state": "TX",
            "postal_code": "786408791",
            "country_code": "US",
            "telephone_number": "512-268-1003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 N Main St Ste 304",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463071877",
            "country_code": "US",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ULLIMAN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011206A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016018",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP142506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.