Individual provider Active NPI

Gina Marie Lum, MSN, FNP

  • Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1598920704
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN13456 Issued in TN
Practice address
7600 Wolf River Blvd
Suite 220
Germantown, TN 38138-1785
Phone
(901) 755-5300
Fax
(901) 756-0196
NPI assigned
Jul 28, 2008
Last updated
Nov 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A810264 MS
Nurse Practitioner 363L00000X APN13456 TN Primary
Pediatric Nurse Practitioner 363LP0200X APN13456 TN
Pediatric Nurse Practitioner 363LP0200X A810264 MS

Addresses

Primary practice location

7600 Wolf River Blvd
Suite 220
Germantown, TN 38138-1785

Mailing address

8001 Centerview Pkwy
Suite 202
Cordova, TN 38018-4228
Phone (901) 755-5300

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)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
A810264MSMDNurse Practitioner
APN13456TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Ear, Nose, and Throat, P.C. CurrentSince Nov 17, 2019 Accepting new patients
Desoto Ear, Nose &Throat PastSince Jun 14, 2020 Accepting new patients
North Internal Medicine, P. C. PastSince Nov 9, 2020 Accepting new patients
Pediatric Emergency Specialists, PC Past Accepting new patients

Locations

7600 Wolf River Blvd
Ste 220
Germantown, TN 38138

Organizations & group practices 4

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": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1598920704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 CENTERVIEW PKWY",
            "address_2": "SUITE 202",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184228",
            "telephone_number": "901-755-5300",
            "fax_number": "901-753-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 WOLF RIVER BLVD",
            "address_2": "SUITE 220",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381785",
            "telephone_number": "901-755-5300",
            "fax_number": "901-756-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUM",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "A810264",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN13456",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "APN13456",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "A810264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.