Individual provider Active NPI

Unwam Jumbo, MD

  • Student in an Organized Health Care Education/Training Program
  • Fairhope, AL
National Provider Identifier
1174250476
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
188 Hospital Dr Ste 402
Fairhope, AL 36532-2018
Phone
(251) 279-1529
Fax
(251) 279-1247
NPI assigned
Aug 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

188 Hospital Dr Ste 402
Fairhope, AL 36532-2018

Mailing address

188 Hospital Dr Ste 402
Fairhope, AL 36532-2018
Phone (251) 279-1529

Other identifiers 1

IdentifierTypeStateIssuer
000000000OtherNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ana.peters@infirmaryhealth.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250818002307 GA Order and Referring Only - Cardiovascular Disease (Cardiology)Practitioner - Cardiovascular Disease (Cardiology) 6608375563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1174250476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 HOSPITAL DR STE 402",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322018",
            "telephone_number": "251-279-1529",
            "fax_number": "251-279-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 HOSPITAL DR STE 402",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322018",
            "telephone_number": "251-279-1529",
            "fax_number": "251-279-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMBO",
        "first_name": "UNWAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "000000000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ana.peters@infirmaryhealth.org",
            "affiliation": "N",
            "endpointDescription": "IH EMail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "None",
            "address_1": "188 Hospital Dr Ste 402",
            "city": "Fairhope",
            "state": "AL",
            "country_code": "US",
            "postal_code": "365322018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.