Individual provider Active NPI

Julie A. Hannah, FNP-BC

  • Family Nurse Practitioner
  • Roseville, CA
National Provider Identifier
1871596353
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010947 Issued in CA
Practice address
151 N Sunrise Ave Ste 1201
Roseville, CA 95661-2961
Phone
(916) 780-0110
Fax
(916) 536-7241
NPI assigned
May 27, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95010947 CA Primary

Addresses

Primary practice location

151 N Sunrise Ave Ste 1201
Roseville, CA 95661-2961

Mailing address

1177 Essington LN
Roseville, CA 95747-9523
Phone (678) 899-1870

Other practice location 1

2 Medical Plaza Dr Ste 175
Roseville, CA 95661-3049
Phone (916) 782-2149

Other names 1

  • Miss Julie A. Ultsch Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20140324000976 GA Practitioner - Nurse Practitioner 5890683536 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95010947CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gwinnett Physician Group, LLC CurrentSince Jan 1, 2014 Accepting new patients
Michael V Abene MD PA PastSince Aug 1, 2012 Accepting new patients
Todd J Swick, MD, PA PastSince Feb 1, 2002 Accepting new patients
Gwinnett Medical Group, Inc Past Accepting new patients

Locations

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

Organizations & group practices 4

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1871596353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 ESSINGTON LN",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957479523",
            "telephone_number": "678-899-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE STE 1201",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612961",
            "telephone_number": "916-780-0110",
            "fax_number": "916-536-7241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Medical Plaza Dr Ste 175",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956613049",
            "country_code": "US",
            "telephone_number": "916-782-2149",
            "fax_number": "916-782-4229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNAH",
        "first_name": "JULIE",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "ULTSCH",
            "middle_name": "A.",
            "prefix": "MISS",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.