Individual provider Active NPI

Diane Lau Lum, M.D.

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1821077975
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E1289 Issued in AR
Practice address
6005 Park Ave Ste 200
Memphis, TN 38119-5212
Phone
(901) 761-2100
NPI assigned
Jan 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 29884 TN
Internal Medicine Physician 207R00000X E1289 AR Primary

Addresses

Primary practice location

6005 Park Ave Ste 200
Memphis, TN 38119-5212

Mailing address

228 W Tyler Ave
Suite 200
West Memphis, AR 72301-4223
Phone (870) 735-1973

Other practice location 1

228 W Tyler Ave
Suite 200
West Memphis, AR 72301-4223
Phone (870) 735-1973

Other identifiers 1

IdentifierTypeStateIssuer
131640001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040603001513 AR Practitioner - Internal Medicine 7911989835 Reassigns benefits to 1 organization
I20141121001690 TN Practitioner - Internal Medicine 7911989835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arkansas College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Physician Network, LLCGroup PAC ID 2365701943, 74 clinicians

Practice addresses (Care Compare)

6005 Park Ave
Suite 200
Memphis, TN 38119-5212
Phone (901) 761-2100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29884TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Blakney Internal Medicine Current Accepting new patients
Saint Francis Physician Network, LLC CurrentSince Feb 5, 2018 Accepting new patients
Saint Francis-Arkansas Physician Network, LLC CurrentSince Feb 5, 2018 Accepting new patients
Internal Medicine Assoc. of West Memphis Internal Medicine Current Accepting new patients
Crittenden Cares, Inc Past Accepting new patients

Locations

310 Judge Smith Dr
Marion, AR 72364
Phone (870) 735-4025

300 S Rhodes St
West Memphis, AR 72301
Phone (870) 400-0433

228 W Tyler Ave
Ste 200
West Memphis, AR 72301
Phone (501) 735-1973

6005 Park Ave
Ste 200
Memphis, TN 38119
Phone (901) 761-2100

6005 Park Ave
Ste 601
Memphis, TN 38119
Phone (901) 680-9205

6005 Park Ave
Ste 323B
Memphis, TN 38119
Phone (901) 756-6991

452 Perkins Ext
Memphis, TN 38117
Phone (901) 730-8300

Interoperability endpoints

  • Direct secure messaging: diane.lum.1@16700.direct.athenahealth.com

Organizations & group practices 5

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 9

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": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1821077975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 W TYLER AVE",
            "address_2": "SUITE 200",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014223",
            "telephone_number": "870-735-1973",
            "fax_number": "870-735-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE STE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195212",
            "telephone_number": "901-761-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 W Tyler Ave",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "West Memphis",
            "state": "AR",
            "postal_code": "723014223",
            "country_code": "US",
            "telephone_number": "870-735-1973",
            "fax_number": "870-735-5433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUM",
        "first_name": "DIANE",
        "middle_name": "LAU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "29884",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E1289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131640001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.