Individual provider Active NPI

John R. Stump, M.D.

  • Ophthalmology Physician
  • Milford, DE
National Provider Identifier
1386641058
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C1-0003146 Issued in DE
Practice address
200 Kona Circle
Milford, DE 19963-1843
Phone
(302) 424-0523
Fax
(302) 424-2415
NPI assigned
Jul 7, 2005
Reactivated
Apr 6, 2006
Last updated
Jun 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X C1-0003146 DE Primary

Addresses

Primary practice location

200 Kona Circle
Milford, DE 19963-1843

Mailing address

200 Kona Circle
Milford, DE 19963-1843
Phone (302) 424-0523

Other identifiers 1

IdentifierTypeStateIssuer
0516920001OtherDEDEMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20051104000193 DE Practitioner - Ophthalmology 9830117282 Practice locations: Milford, DE

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Consultants of Delmarva PA Ophthalmology PastSince Mar 17, 2012 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1386641058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 KONA CIRCLE",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631843",
            "telephone_number": "302-424-0523",
            "fax_number": "302-424-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 KONA CIRCLE",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631843",
            "telephone_number": "302-424-0523",
            "fax_number": "302-424-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUMP",
        "first_name": "JOHN",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-06-16",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "DE",
            "license": "C1-0003146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEMERC",
            "identifier": "0516920001",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

Verify at the official NPI Registry.