Individual provider Active NPI

Lynne M Mumaw, GNP

  • Gerontology Nurse Practitioner
  • Eugene, OR
National Provider Identifier
1407891310
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
200250107NP Issued in OR
Practice address
4010 Aerial Way
Eugene, OR 97402-9757
Phone
(541) 242-8300
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 200250107NP OR Primary

Addresses

Primary practice location

4010 Aerial Way
Eugene, OR 97402-9757

Mailing address

PO Box 24410
Eugene, OR 97402-0451
Phone (541) 984-4301

Other identifiers 1

IdentifierTypeStateIssuer
000594MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230222001853 VA Practitioner - Nurse Practitioner 3779610035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Wound Care Virginia PLLC CurrentSince Dec 1, 2022 Accepting new patients
Signify Health, LLC CurrentSince Oct 13, 2022 Accepting new patients

Locations

492C Cedar Ln
Teaneck, NJ 07666
Phone (201) 357-5468

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

1806 Summit Ave
Richmond, VA 23230
Phone (213) 433-2823

324 King George Ave SW
Roanoke, VA 24016
Phone (540) 309-9895

Interoperability endpoints

  • Direct secure messaging: lmumaw2017@direct.peacehealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1407891310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24410",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974020451",
            "telephone_number": "541-984-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 AERIAL WAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974029757",
            "telephone_number": "541-242-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMAW",
        "first_name": "LYNNE",
        "middle_name": "M",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "200250107NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000594",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.