Rebecca Sue Gump, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

71000263A Issued in IN

Practice address

2121 Lake Ave
Fort Wayne, IN 46805-5100

Phone

(260) 426-5431

Fax

(260) 460-1425

NPI assigned

Aug 18, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780798694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9030 MCCOMB RD",
            "city": "CHURUBUSCO",
            "state": "IN",
            "postal_code": "467239441",
            "telephone_number": "260-693-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "260-426-5431",
            "fax_number": "260-460-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMP",
        "first_name": "REBECCA",
        "middle_name": "SUE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71000263A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Gullion, ATC
• Melissa S Gumbert, ATC,LAT
• P. Rao Gummadi, M.D.
• Amanda Gump
• Mateo Gump, RBT
• Bonnie L. Gunckel, RD LD
• Gay Gundersen Watson, RN FNP
• Beverly B Gunn, RPH
• Rashonda Gunn
• Rakesh K Guntur, M.D.

• Adult Health Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Adult Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.