Active NPI
Teresa Marie Lum, CRNP
- Pediatric Nurse Practitioner
- Hagerstown, MD
National Provider Identifier
1245260355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- R109055
- Practice address
- 265 Mill St
Suite 800
Hagerstown, MD 21740-6130 - Phone
- (240) 513-4595
- Fax
- (240) 513-4596
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | R109055 | MD | Primary |
Addresses
Primary practice location
265 Mill St
Suite 800
Hagerstown, MD 21740-6130
Mailing address
265 Mill St
Suite 800
Hagerstown, MD 21740-6130
Phone (240) 513-4595
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807602200 | Medicaid | MD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R109055 | MD | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Simply 4 Kidz Healthcare, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632960000000",
"number": "1245260355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "265 MILL ST",
"address_2": "SUITE 800",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217406130",
"telephone_number": "240-513-4595",
"fax_number": "240-513-4596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 MILL ST",
"address_2": "SUITE 800",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217406130",
"telephone_number": "240-513-4595",
"fax_number": "240-513-4596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUM",
"first_name": "TERESA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2021-09-30",
"certification_date": "2021-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MD",
"license": "R109055",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807602200",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.