Kimberly Louise Bumper
Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Oxford, NC
NPI 1679606149 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1679606149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
- License
- MHL-039-042 (NC)
- Practice address
- 115 Frost St
Oxford, NC 27565-3441 - Phone
- (191) 969-3796
- Fax
- (191) 969-3696
- NPI assigned
- Mar 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MHL-039-042 | NC | MD | Intellectual and/or Developmental Disabilities Residential Treatment Facility |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | MHL-039-042 | NC | Yes |
Addresses
Primary practice location
115 Frost St
Oxford, NC 27565-3441
Mailing address
115 Frost St
Oxford, NC 27565-3441
Phone (191) 969-3796
Other providers in Oxford, NC
- Millicent Bryanne Brown
- Janaye Bryant
- Scott Lee Buckel
- Eric Martin Buenviaje
- Building Blocks Developmental Therapy
- Claudia M Burns
- Tina Burwell
- C & J Bradshaw, LLC
- C&C Innovations LLC
- Dana Deneen Cage
All providers in Oxford, NC · Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.