Elizabeth W Mumaw, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2017-01320 Issued in NC

Practice address

504 N Greensboro St
Liberty, NC 27298

Phone

(336) 622-4850

Fax

(336) 622-4855

NPI assigned

Jun 27, 2014

Last updated

Oct 25, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elizabethmumaw@rma.allscriptsdirect.net
• Direct secure messaging: emumaw2754886@carolinashealthcaresystem.direct-ci.com
• FHIR API: https://fhir4.healow.com/fhir/r4/AIBJAD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Moses H Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1356372064

  Family Medicine

  Medicare reassignment NPD
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment NPD
• United Health Center

  • Federally Qualified Health Center (FQHC)
  • Winston Salem, NC
  • NPI 1811136476
  NPD (past)
• United Health Centers

  • General Practice Dentistry
  • Winston Salem, NC
  • NPI 1285120816
  NPD (past)

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1841605979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 FOUST ST STE C",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035476",
            "telephone_number": "336-625-2333",
            "fax_number": "336-625-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N GREENSBORO ST",
            "city": "LIBERTY",
            "state": "NC",
            "postal_code": "27298",
            "telephone_number": "336-622-4850",
            "fax_number": "336-622-4855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16001 W 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480754818",
            "country_code": "US",
            "telephone_number": "248-849-8483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUMAW",
        "first_name": "ELIZABETH",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2017-01320",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2017-01320",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841605979",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "19T8H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Deborah E Meridith, LRT/CTRS
• Jennifer Vanita Moore, LMBT
• North Carolina CVS Pharmacy LLC (CVS Pharmacy #05377)
• Occupational Health Centers of North Carolina PC (Concentra - Toyota TBMNC Onsite)
• Payless Medical Supplies, LLC (One Source Medical Group)
• Caroline June Peter, R.PH.
• Phoenix Professional Services

• Family Medicine Physician in Liberty, NC
• Providers in Liberty, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.