Individual provider Active NPI

Ellen Marie Uller, CNM, NP

  • Advanced Practice Midwife
  • Fresno, CA
National Provider Identifier
1396835518
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
1265 Issued in CA
Practice address
290 N Wayte LN
Fresno, CA 93701-2124
Phone
(559) 459-5755
Fax
(559) 459-4453
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 327 NC
Obstetrics & Gynecology Nurse Practitioner 363LX0001X NP9321 CA
Advanced Practice Midwife 367A00000X 1265 CA Primary
Nurse Practitioner 363L00000X NP9321 CA
Registered Nurse 163W00000X RN500942 CA

Addresses

Primary practice location

290 N Wayte LN
Fresno, CA 93701-2124

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682

Other identifiers 1

IdentifierTypeStateIssuer
327OtherNCNURSE MIDWIFERY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN500942CAMDRegistered Nurse
327NCMDMidwife
1265CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
University Faculty Associates, Inc. Past Accepting new patients
Integrative Womens Care PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ellen.uller.1@27069.direct.athenahealth.com

Organizations & group practices 2

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1396835518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 N WAYTE LN",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012124",
            "telephone_number": "559-459-5755",
            "fax_number": "559-459-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLER",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "credential": "CNM, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NC",
            "license": "327",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "NP9321",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1265",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP9321",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN500942",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE MIDWIFERY",
            "identifier": "327",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.