Pennica Marie Mumford, BSN,MSN, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

RN168735 Issued in GA

Practice address

1395 Eisenhower Dr
Savannah, GA 31406-3901

Phone

(912) 656-4456

Fax

(912) 721-0121

NPI assigned

Mar 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 10

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Master of Science - Nursing, Registered Nurse

State licenses

Practice roles

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.

• Mumford Telehealth Services

  • Community/Behavioral Health Agency
  • Savannah, GA
  • NPI 1639580186
  NPD (past) Authorized official

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1205394822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 FENWICK VILLAGE DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314195513",
            "telephone_number": "912-844-6497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 EISENHOWER DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063901",
            "telephone_number": "912-656-4456",
            "fax_number": "912-721-0121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4113 Fenwick Village Dr",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314195513",
            "country_code": "US",
            "telephone_number": "912-844-6497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUMFORD",
        "first_name": "PENNICA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "BSN,MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "GA",
            "license": "RN168735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaycee Mullis, RBT
• Sandra Mullis, M.S., CCC-SLP
• Bridget Mary Mulroy, DPT
• Gloria Mulvaney, NP
• Mumford Telehealth Services
• Barbara B Munro, MSW
• Liudmila Muraveika, MD
• Megan P. Murphree, FNP-C
• Gina Murphy, PT
• Julie Karen Holbrook Murphy, WHNP

• General Practice Registered Nurse in Savannah, GA
• Providers in Savannah, GA by specialty
• General Practice Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.