Jerelyn J. Gumerson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71000562A Issued in IN

Practice address

3834 S Emerson Ave
Building C, Suite 100
Indianapolis, IN 46203

Phone

(317) 782-1577

Fax

(317) 780-5539

NPI assigned

Feb 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Indiana Geriatric Associates, P.C.

  • Geriatric Psychiatry Physician
  • Carmel, IN
  • NPI 1922071638
  NPD (past)
• St. Vincent Hospital & Health Care Center, Inc.

  • Community/Retail Pharmacy
  • Indianapolis, IN
  • NPI 1194929646
  NPD (past)
• St. Vincent Hospital & Health Care Center, Inc.

  • Psychiatry Physician
  • Indianapolis, IN
  • NPI 1689869893
  NPD (past)

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

{
    "created_epoch": "1139702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1912970625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3299",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897023299",
            "telephone_number": "775-222-0044",
            "fax_number": "888-700-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3834 S EMERSON AVE",
            "address_2": "BUILDING C, SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46203",
            "telephone_number": "317-782-1577",
            "fax_number": "317-780-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMERSON",
        "first_name": "JERELYN",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-12",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "71000562A",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "IN",
            "license": "71000562A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000562A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PIN",
            "identifier": "P01424889",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200215810",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David J Gulliver, MD
• Hitesh Gulliya, DO
• Alexis Michael Gully, MSW, LCSW
• Carolyn Jean Gum, M.S.,P.T.
• Gwyn Gumalo
• Chloe Gumm
• Brittany Nicole Gummere, MSW
• Shivaji R Gunale, M.D.
• Julie Gunckle, FNP
• David Gunderman, PHD

• Family Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.