Individual provider Active NPI

Gina M Sumpter, NP

  • Family Nurse Practitioner
  • Mentor, OH
National Provider Identifier
1164916003
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.021889 Issued in OH
Practice address
9485 Mentor Avenue
Suite 210
Mentor, OH 44060
Phone
(440) 255-5571
Fax
(440) 205-5744
NPI assigned
Jun 14, 2018
Last updated
Jun 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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 APRN.CNP.021889 OH Primary

Addresses

Primary practice location

9485 Mentor Avenue
Suite 210
Mentor, OH 44060

Mailing address

11149 Caddie LN
Concord TWP, OH 44077-8939
Phone (440) 415-5210

Other practice location 1

2026 State Route 45
Austinburg, OH 44010-9711
Phone (440) 275-3019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180719004009 OH Practitioner - Nurse Practitioner 0941557029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Hospital System, Inc.Group PAC ID 6002713922, 92 clinicians

Practice addresses (Care Compare)

9485 Mentor Ave
Suite 210
Mentor, OH 44060-8723
Phone (440) 205-5835

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc. CurrentSince Jul 12, 2021 Accepting new patients
Lake Hospital System, Inc CurrentSince Jul 12, 2021 Accepting new patients
Lake Hospital System Inc Current Accepting new patients

Locations

7590 Auburn Rd
Ste 14
Concord Township, OH 44077
Phone (440) 354-1899

9485 Mentor Ave
Ste 210
Mentor, OH 44060
Phone (440) 255-5571

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

Interoperability endpoints

  • Direct secure messaging: gsumpter28037@ehrdirect.uhhospitals.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1164916003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11149 CADDIE LN",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440778939",
            "telephone_number": "440-415-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9485 MENTOR AVENUE",
            "address_2": "SUITE 210",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "44060",
            "telephone_number": "440-255-5571",
            "fax_number": "440-205-5744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2026 State Route 45",
            "address_purpose": "LOCATION",
            "city": "Austinburg",
            "state": "OH",
            "postal_code": "440109711",
            "country_code": "US",
            "telephone_number": "440-275-3019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMPTER",
        "first_name": "GINA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.021889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.