NPIMap

Organization Active NPI

Mumford Telehealth Services

  • Community/Behavioral Health Agency
  • Savannah, GA
National Provider Identifier
1639580186
Registry record updated May 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
RN168735 Issued in GA
Legal business name
MUMFORD TELEHEALTH SERVICES
Practice address
4113 Fenwick Village Dr
Savannah, GA 31419-5513
Phone
(912) 844-6497
NPI assigned
May 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2014

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

Authorized official

Name
Ms. Pennica Mumford Mumford, RNNPI 1205394822
Title
Ceo
Phone
(912) 844-6497

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X RN168735 GA
Public Health or Welfare Agency 251K00000X RN168735 GA
Community/Behavioral Health Agency 251S00000X RN168735 GA Primary
Early Intervention Provider Agency 252Y00000X RN168735 GA
In Home Supportive Care Agency 253Z00000X RN168735 GA
Rural Health Clinic/Center 261QR1300X RN168735 GA

Addresses

Primary practice location

4113 Fenwick Village Dr
Savannah, GA 31419-5513

Mailing address

4113 Fenwick Village Dr
Savannah, GA 31419-5513
Phone (912) 844-6497

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400284800000",
    "number": "1639580186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 FENWICK VILLAGE DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314195513",
            "telephone_number": "912-844-6497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 FENWICK VILLAGE DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314195513",
            "telephone_number": "912-844-6497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUMFORD TELEHEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-17",
        "last_updated": "2014-05-17",
        "status": "A",
        "authorized_official_last_name": "MUMFORD",
        "authorized_official_first_name": "PENNICA",
        "authorized_official_middle_name": "MUMFORD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-844-6497",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "RN168735",
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "GA",
            "license": "RN168735",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2014; 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.