Brennan Ullom, APRN, FNP-C in Medford, OR - Medicare Nurse Practitioner

Brennan Ullom, APRN, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Medford, Oregon. His current practice location is 3156 State St, Medford, Oregon. You can reach out to his office (for appointments etc.) via phone at (541) 773-9772.

Brennan Ullom is licensed to practice in Oregon (license number 10038862) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1851104400.

Contact Information

	Brennan Ullom, APRN, FNP-C
	3156 State St, Medford, OR 97504-8450
	(541) 773-9772
	(541) 773-1113

Map and Direction

Provider's Profile

Full Name	Brennan Ullom
Gender	Male
Speciality	Nurse Practitioner - Family
Location	3156 State St, Medford, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1851104400
Provider Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025

Medicare PECOS Information:

PECOS PAC ID: 0143741835
Enrollment ID: I20250311001121

Medical Identifiers

Medical identifiers for Brennan Ullom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1851104400	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	201905568RN (Oregon)	Secondary
363LF0000X	Nurse Practitioner - Family	10038862 (Oregon)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brennan Ullom allows following entities to bill medicare on his behalf.

Entity Name	Complete Integrative Care, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073061099 PECOS PAC ID: 0244510261 Enrollment ID: O20161209000369

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brennan Ullom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Brennan Ullom, APRN, FNP-C 3156 State St, Medford, OR 97504-8450 Ph: () -	Brennan Ullom, APRN, FNP-C 3156 State St, Medford, OR 97504-8450 Ph: (541) 773-9772

Reviews and Comments

Nurse Practitioner Nurses in Medford, OR

Carla Ann Cochran, NP-C, FNP, AGACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 555 Black Oak Dr., Suite 300, Medford, OR 97504 Phone: 903-463-0003
Christine Ann Stanek, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2859 State Street, Suite 101, Medford, OR 97504 Phone: 541-282-6505 Fax: 541-282-6520
Lena Lori Varner, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 520 Medical Center Dr Ste 300, Medford, OR 97504 Phone: 541-930-8907 Fax: 541-245-4820
Jessica Faith Yeager Akram, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2860 Creekside Cir, Medford, OR 97504 Phone: 541-779-8367
Mrs. Lauren E Hodgdon, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1698 E Mcandrews Rd Ste 200, Medford, OR 97504 Phone: 541-732-5537
Kaitlin Eileen Stapleton, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2900 State St, Medford, OR 97504 Phone: 541-779-1672
Elizabeth L Pethtel, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3170 State St, Medford, OR 97504 Phone: 541-864-8900 Fax: 541-245-3315

Brennan Ullom, APRN, FNP-C - Medicare Nurse Practitioner in Medford, OR