Molly Marie Ullenberg, AGPCNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

7448 Issued in WI

Practice address

16655 W Bluemound Rd
Brookfield, WI 53005-5957

Phone

(414) 257-1708

Fax

(414) 257-1787

NPI assigned

Mar 20, 2017

Last updated

Mar 20, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in WI

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 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1689115818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16655 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055957",
            "telephone_number": "414-257-1708",
            "fax_number": "414-257-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16655 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055957",
            "telephone_number": "414-257-1708",
            "fax_number": "414-257-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLENBERG",
        "first_name": "MOLLY",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "7448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Turley, DNP
• Tiaira A Turner
• Olivia Twitchell, RN
• U.S. Medgroup, P.a.
• Elizabeth Udovich, DPT
• Amy Unger, SLP
• Unlimited Home Care LLC
• US Medgroup PA (Advanced Medical Specialists)
• USA Vein Clinics of Wisconsin LLC
• Marie Therese Ustruck, FNP

• Primary Care Nurse Practitioner in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Primary Care Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.