Individual provider Active NPI

Gregory H. Mumma, PH.D.

  • Clinical Psychologist
  • Lubbock, TX
National Provider Identifier
1881723674
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2-3791 Issued in TX
Practice address
3709 22ND PL Unit C
Lubbock, TX 79410-1333
Phone
(806) 559-6480
Fax
(806) 795-2315
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2-3791 TX Primary

Addresses

Primary practice location

3709 22ND PL Unit C
Lubbock, TX 79410-1333

Mailing address

3709 22ND PL Unit C
Lubbock, TX 79410-1333
Phone (806) 559-6480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100719000788 TX Practitioner - Clinical Psychologist 2668504143 Practice locations: Lubbock, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3709 22ND PL
Unit C
Lubbock, TX 79410-1333
Phone (806) 834-3757

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2-3791TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Associates Clinical PastSince Nov 10, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1881723674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 22ND PL UNIT C",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101333",
            "telephone_number": "806-559-6480",
            "fax_number": "806-795-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 22ND PL UNIT C",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101333",
            "telephone_number": "806-559-6480",
            "fax_number": "806-795-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMMA",
        "first_name": "GREGORY",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "2-3791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.