Regina Z Gum, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-06084 Issued in NC

Practice address

5130 Southport Supply Rd SE
Ste 101
Southport, NC 28461-9261

Phone

(910) 269-4053

Fax

(910) 363-4905

NPI assigned

Nov 2, 2005

Last updated

Mar 7, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Northern Greenbrier Health Clinic, Inc

  • Family Medicine Physician
  • Hillsboro, WV
  • NPI 1629283536
  NPD (past)
• Northern Greenbrier Health Clinic, Inc

  • Family Medicine Physician
  • Williamsburg, WV
  • NPI 1932203122
  NPD (past)
• Samuel K Roberts MD PC

  • Family Medicine Physician
  • Elkins, WV
  • NPI 1457333403
  NPD (past)
• Valley Health Care Inc.

  • Federally Qualified Health Center (FQHC)
  • Beverly, WV
  • NPI 1073244810
  NPD (past)
• Wythville Management Consultants LLC,

  dba Physician Quick Care Plus

  • Specialist
  • Lewisburg, WV
  • NPI 1598756207
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1427049121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 SOUTHPORT SUPPLY RD SE",
            "address_2": "STE 101",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284619261",
            "telephone_number": "910-269-4053",
            "fax_number": "910-363-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 SOUTHPORT SUPPLY RD SE",
            "address_2": "STE 101",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284619261",
            "telephone_number": "910-269-4053",
            "fax_number": "910-363-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUM",
        "first_name": "REGINA",
        "middle_name": "Z",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "301",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-06084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Garrett
• Sue Leeuwenburg Gibson, RPH
• Goshen Medical Center Incorporated (Goshen Medical Center - Southport)
• Goshen Medical Center Incorporated (GMC Pharmacy at Southport)
• Jeremy Brian Grissett, DPT
• Lenard Clifton Hammond, DC
• Deborah Hanna, LPC,LMFT
• Harmony Dental of Southport
• Ashley Pace Harrington, MPT
• Ziaollah Hashemi, M.D.

• Medical Physician Assistant in Southport, NC
• Providers in Southport, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.