Robert a Pumpelly IV MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

022461 Issued in GA

Legal business name

ROBERT A PUMPELLY IV MD PC

Practice address

124 Memorial Dr
Jesup, GA 31545-0101

Phone

(912) 427-4413

Fax

(912) 530-6348

NPI assigned

Nov 22, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Nancy Hoover

Title

Office Manager

Phone

(912) 427-4413

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Karen E. Bamberg, ANP-BC

  • Adult Health Nurse Practitioner
  • Jesup, GA
  • NPI 1437409331
  Medicare reassignment Care Compare group NPD
• Robert Allen Pumpelly IV, MD

  • Internal Medicine Physician
  • Jesup, GA
  • NPI 1235121658
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255406229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MEMORIAL DR",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450101",
            "telephone_number": "912-427-4413",
            "fax_number": "912-530-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MEMORIAL DR",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450101",
            "telephone_number": "912-427-4413",
            "fax_number": "912-530-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A PUMPELLY IV MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOOVER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-427-4413",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "022461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300024546",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CH9108",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brigitta Rodriguez
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• Internal Medicine Physician in Jesup, GA
• Providers in Jesup, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.