Jeffery Lane Ulmer, P.A.-C.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-116 Issued in AR

Practice address

1102 Crestwood Cir
Mena, AR 71953-5513

Phone

(479) 394-7301

Fax

(479) 394-7160

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1225072614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 CRESTWOOD CIR",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719535513",
            "telephone_number": "479-394-7301",
            "fax_number": "479-394-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CRESTWOOD CIR",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719535513",
            "telephone_number": "479-394-7301",
            "fax_number": "479-394-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULMER",
        "first_name": "JEFFERY",
        "middle_name": "LANE",
        "name_prefix": "Mr.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": "PA-116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chau Tran, PHARMD
• Rhonda Tranter, RN
• Barbara Travis, APRN
• TTJ, Inc
• Farrah Nicole Tucker Jordan
• David Wayne Vanwinkle, D.D.S.
• Wal-Mart Stores, Inc.
• Walgreen Co
• Walk in Center
• Robbie Gene Walker, OTR/L

• Medical Physician Assistant in Mena, AR
• Providers in Mena, AR by specialty
• Medical Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.