Kimberly Susan Stump, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD194544 Issued in OR

Practice address

900 State St
Salem, OR 97301-3922

Phone

(503) 370-6062

NPI assigned

Jun 28, 2007

Last updated

Sep 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Health and Human Services Commission

  dba Rio Grande State Center

  • Clinical Neuropsychologist
  • Harlingen, TX
  • NPI 1356414692
  Medicare reassignment NPD
• Health and Human Services Commission

  dba Big Spring State Hospital

  • Psychiatric Hospital
  • Big Spring, TX
  • NPI 1881600682
  NPD

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1063619518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5536 SALAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973062184",
            "telephone_number": "214-418-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013922",
            "telephone_number": "503-370-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUMP",
        "first_name": "KIMBERLY",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NH",
            "license": "RT1676",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P1496",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD194544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ahmann Strunk, B.A.
• Tammy M Stuber, APRN-NP
• Thomas George Stuck, M.A.
• Nicole Stuckart
• Mackenzie Stueve, CSWA
• Patricia Lorraine Stupfel, ANP
• Matthew James Sturgeon, PSY.D.
• Cassandra Marie Sturtz
• Jenna N Sturzinger, MPT
• Lyndsay R Stutzenberger, P.T., D.P.T.

• Family Medicine Physician in Salem, OR
• Providers in Salem, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.