Basic Information
| Provider Information | |||||||||
| NPI: | 1437148947 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JUMPER | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 27476 | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841270476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067436759 | ||||||||
| FaxNumber: | 8067433576 | ||||||||
| Practice Location | |||||||||
| Address1: | 3601 4TH ST | ||||||||
| Address2: | 4C201 | ||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794309410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067433150 | ||||||||
| FaxNumber: | 8067433168 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2005 | ||||||||
| LastUpdateDate: | 01/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | H6323 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | H6323 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | H6323 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 116311100 | 01 | TX | FIRSTCARE COMMERCIAL | OTHER | 130425504 | 05 | TX | MEDICAID | 37965 | 05 | NM | MEDICAID | A142 | 01 | NM | TRIWEST | OTHER | 000F5278 | 05 | NM | MEDICAID | 116311101 | 05 | TX | MEDICAID | 37965 | 01 | NM | PRESBYTERIAN COMMERCIAL | OTHER | 100153870A | 05 | OK | MEDICAID | 130425502 | 05 | TX | MEDICAID | 80757Z | 01 | TX | HMO BLUE | OTHER | 85E054 | 01 | TX | BC/BS | OTHER |