Individual provider Active NPI

Jennifer L Kumin, APRN

  • Primary Care Nurse Practitioner
  • Dover, NH
National Provider Identifier
1750704466
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
069192-23 Issued in NH
Practice address
15 Old Rollinsford Rd
Suite 204
Dover, NH 03820-2868
Phone
(603) 742-7338
Fax
(603) 740-9528
NPI assigned
Jan 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 069192-23 NH Primary
Family Nurse Practitioner 363LF0000X CNP141008 ME

Addresses

Primary practice location

15 Old Rollinsford Rd
Suite 204
Dover, NH 03820-2868

Mailing address

789 Central Ave
Dover, NH 03820-2526
Phone (603) 742-7338

Other identifiers 2

IdentifierTypeStateIssuer
1750704466MedicaidME
3096141MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20140331001163 NH Practitioner - Nurse Practitioner 6608007901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10 Members Way
200 Prompt Care
Dover, NH 03820-5933
Phone (603) 609-6930

Hospital & facility affiliations

  • Wentworth Home Care & Hospice, an Amedisys Partner Home health agency, Somersworth, NH, CCN 307014
  • Cornerstone Vna Home health agency, Rochester, NH, CCN 307022
  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Hospital Current Accepting new patients
Westchester Neurological Consultant PC Past Accepting new patients

Locations

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

Interoperability endpoints

  • Direct secure messaging: kumin.jennifer.wdh@direct.partners.masshiway.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1750704466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-742-7338",
            "fax_number": "603-740-9528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OLD ROLLINSFORD RD",
            "address_2": "SUITE 204",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202868",
            "telephone_number": "603-742-7338",
            "fax_number": "603-740-9528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMIN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-31",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NH",
            "license": "069192-23",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP141008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750704466",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3096141",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.