NPIMap

Individual provider Active NPI

Laurence Lum, D.O.

  • Family Medicine Physician
  • Desloge, MO
National Provider Identifier
1932193554
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
104007 Issued in MO
Practice address
330 N State St
Suite C
Desloge, MO 63601-3052
Phone
(573) 431-4449
Fax
(573) 431-2443
NPI assigned
Sep 9, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 104007 MO Primary

Addresses

Primary practice location

330 N State St
Suite C
Desloge, MO 63601-3052

Mailing address

330 N State St
Suite C
Desloge, MO 63601-3052
Phone (573) 431-4449

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100611000663 MO Practitioner - Family Practice 8224126867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Quality Health Care, IncGroup PAC ID 7911937842, 3 clinicians

Practice addresses (Care Compare)

330 N State St
Suite C
Desloge, MO 63601-3041
Phone (573) 431-5177

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104007MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Health Care, Inc. CurrentSince Jul 17, 1995 Accepting new patients
Quality Health Care, Inc Family Medicine CurrentSince Jul 17, 1995 Accepting new patients
Camelot Healthcare, LLC Past Accepting new patients
American Nursing & Rehab LLC Past Accepting new patients
N & R of Farmington, LLC Past Accepting new patients
Mineral Area Pain Center, P.C. Family Medicine PastSince Jan 5, 1998 Accepting new patients
Eldercare of Mid-Missouri IV, Inc. Past Accepting new patients
Missouri Nursing Home & Rehab LLC Past Accepting new patients
Country Meadows Nursing & Rehab LLC Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients
Midwest Health Group Convenient Care, LLC Past Accepting new patients
Georgian Gardens Healthcare LLC Past Accepting new patients

Locations

330 N State St
Ste C
Desloge, MO 63601
Phone (314) 431-2829

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Stonebridge DesotoDe Soto, MO, CCN 265772 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2020
Jan 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1932193554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N STATE ST",
            "address_2": "SUITE C",
            "city": "DESLOGE",
            "state": "MO",
            "postal_code": "636013052",
            "telephone_number": "573-431-4449",
            "fax_number": "573-431-2443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N STATE ST",
            "address_2": "SUITE C",
            "city": "DESLOGE",
            "state": "MO",
            "postal_code": "636013052",
            "telephone_number": "573-431-4449",
            "fax_number": "573-431-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUM",
        "first_name": "LAURENCE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "104007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desloge, MO

Sources for this page

Verify at the official NPI Registry.