Individual provider Active NPI

Kendra Jawuane Lumpkin, RN

  • Registered Nurse
  • Lawrenceville, GA
National Provider Identifier
1235807835
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN228665 Issued in GA
Practice address
5415 Sugarloaf Pkwy Ste 1108
Lawrenceville, GA 30043-7832
Phone
(478) 244-1319
NPI assigned
Aug 31, 2021
Last updated
Aug 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN228665 GA Primary

Addresses

Primary practice location

5415 Sugarloaf Pkwy Ste 1108
Lawrenceville, GA 30043-7832

Mailing address

867 E Flournoy Rd
Hawkinsville, GA 31036-9082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN228665GAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1235807835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 E FLOURNOY RD",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310369082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 SUGARLOAF PKWY STE 1108",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437832",
            "telephone_number": "478-244-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMPKIN",
        "first_name": "KENDRA",
        "middle_name": "JAWUANE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN228665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.