Active NPI
Andrew David Mumma, MD
- Student in an Organized Health Care Education/Training Program
- Philadelphia, PA
National Provider Identifier
1629508049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- MT213592
- Practice address
- 833 Chestnut St Ste 210
Philadelphia, PA 19107-4405 - Phone
- (215) 955-8420
- NPI assigned
- Jun 18, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MT213592 | PA | Primary |
Addresses
Primary practice location
833 Chestnut St Ste 210
Philadelphia, PA 19107-4405
Mailing address
833 Chestnut St Ste 210
Philadelphia, PA 19107-4405
Phone (215) 955-8420
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT213592 | PA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1629508049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 CHESTNUT ST STE 210",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074405",
"telephone_number": "215-955-8420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 CHESTNUT ST STE 210",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074405",
"telephone_number": "215-955-8420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUMMA",
"first_name": "ANDREW",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-18",
"last_updated": "2021-06-30",
"certification_date": "2021-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "MT213592",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.