Fawn Shelley Mumbulo, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F338835-1 Issued in NY

Practice address

1 Atwell Rd
Cooperstown, NY 13326-1394

Phone

(607) 547-3480

NPI assigned

Jun 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Chenango Memorial Hospital IncGroup PAC ID 7517853633, 108 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chenango Memorial Hospital Hospital, Norwich, NY, CCN 330033
• Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136
• Aurelia Osborn Fox Memorial Hospital Hospital, Oneonta, NY, CCN 330085

Merit-based Incentive Payment System (MIPS)

Final score

93.4 of 100Reported as group

Quality

86.36

Promoting interoperability

99

Improvement activities

40

Cost

79.9

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Chenango Memorial Hospital Inc

  • General Acute Care Hospital
  • Norwich, NY
  • NPI 1770593956
  Medicare reassignment Care Compare group NPD
• Mary Imogene Bassett Hospital

  • Multi-Specialty Clinic/Center
  • Cooperstown, NY
  • NPI 1083664221
  Medicare reassignment Care Compare group
• Chenango Memorial Hospital Inc

  • Durable Medical Equipment & Medical Supplies
  • Norwich, NY
  • NPI 1437818622
  NPD
• Chenango Memorial Hospital, Inc.

  • Family Medicine Physician
  • Norwich, NY
  • NPI 1467526889
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aurelia Osborn Fox Memorial Hospital Society

  • General Acute Care Hospital
  • Oneonta, NY
  • NPI 1578529954
  Care Compare affiliation
• Chenango Memorial Hospital Inc

  • General Acute Care Hospital
  • Norwich, NY
  • NPI 1770593956
  Care Compare affiliation
• Chenango Memorial Hospital, Inc.

  • Family Medicine Physician
  • Norwich, NY
  • NPI 1467526889

  Hospital

  Care Compare affiliation
• Mary Imogene Bassett Hospital

  • Rural Acute Care Hospital
  • Cooperstown, NY
  • NPI 1780600577
  Care Compare affiliation

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1720493984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261394",
            "telephone_number": "607-547-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261394",
            "telephone_number": "607-547-3480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Chapel St",
            "address_purpose": "LOCATION",
            "city": "Sherburne",
            "state": "NY",
            "postal_code": "134609753",
            "country_code": "US",
            "telephone_number": "607-674-2445",
            "fax_number": "607-674-4338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUMBULO",
        "first_name": "FAWN",
        "middle_name": "SHELLEY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338835-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Moss, M.S.
• Taylor Mostert
• Jennifer Mouriz, MD
• Patricia Manion Mower, M.D.
• Christian J Mulik, M.D.
• Ruvarashe Trish Mupedziswa, MD
• William H Murdock
• Angela M Murphy, FNP
• Derek James Murphy, PTA
• Jeffrey R Murray, M.D.

• Family Nurse Practitioner in Cooperstown, NY
• Providers in Cooperstown, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.