Individual provider Active NPI

Marilyn Bumgarner

  • Pediatric Nurse Practitioner
  • Lynchburg, VA
National Provider Identifier
1497822399
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024078254 Issued in VA
Practice address
1212 McConville Rd
Lynchburg, VA 24502-4536
Phone
(434) 237-8886
Fax
(434) 239-6807
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024078254 VA Primary

Addresses

Primary practice location

1212 McConville Rd
Lynchburg, VA 24502-4536

Mailing address

126 Green Hill Dr
Forest, VA 24551-4015
Phone (434) 237-6186

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

LicenseStateTypeSpecialty
0024078254VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group Past Accepting new patients
F Read Hopkins Pediatric Assoc Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497822399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 GREEN HILL DR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514015",
            "telephone_number": "434-237-6186",
            "fax_number": "434-239-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 MCCONVILLE RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245024536",
            "telephone_number": "434-237-8886",
            "fax_number": "434-239-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMGARNER",
        "first_name": "MARILYN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024078254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.