Jacob E. Ulmer III, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10071 Issued in MS

Practice address

1500 Hwy 19 N
Meridian, MS 39307-5335

Phone

(601) 483-5353

Fax

(601) 482-1753

NPI assigned

Nov 18, 2005

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1285616896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5166",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025166",
            "telephone_number": "601-703-4282",
            "fax_number": "601-703-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 HWY 19 N",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075335",
            "telephone_number": "601-483-5353",
            "fax_number": "601-482-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULMER",
        "first_name": "JACOB",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "10071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009815300",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF AL",
            "identifier": "730-70963",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080050994",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00114181",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marshall Scott Tynes, DO
• U Matter LLC
• Ubs Caregiver Agency Inc
• Ubs Caregiver Agency Inc
• Ubs Caregiver Agency Inc
• Owen Ulmer
• Imran Umer, MD
• Danni Upperman, NP-C
• Urology Clinic of Meridian, P.a.
• James Lee Valentine, D.O.

• Family Medicine Physician in Meridian, MS
• Providers in Meridian, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.