Individual provider Active NPI

Jacob A Humphrey, MD

  • Pediatric Nephrology Physician
  • Atlanta, GA
National Provider Identifier
1003340472
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
105633 Issued in GA
Practice address
2174 N Druid Hills Rd NE
Atlanta, GA 30329-3102
Phone
(404) 785-5437
NPI assigned
Apr 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 105633 GA Primary

Addresses

Primary practice location

2174 N Druid Hills Rd NE
Atlanta, GA 30329-3102

Mailing address

2174 N Druid Hills Rd NE
Atlanta, GA 30329-3102

Other practice location 1

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4531

Other practice location 2

500 S Preston St Rm 305
Louisville, KY 40202-1702
Phone (502) 852-8696

Other practice location 3

2174 N Druid Hills Rd NE
Atlanta, GA 30329-3102
Phone (404) 785-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20250930000404 GA Practitioner - Nephrology 5193051613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Louisville School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choa Multispecialty, LLCGroup PAC ID 7719126820, 35 clinicians

Practice addresses (Care Compare)

1001 Johnson Ferry Nerd
Atlanta, GA 30342-1605
Phone (404) 785-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Choa Multispecialty, LLC Pediatric Nephrology CurrentSince Aug 15, 2025 Accepting new patients
Egleston Pediatric Group Current Accepting new patients
Choa Hospital Based, LLC Current Accepting new patients
Arthur M. Blank Hospital, Inc. Past Accepting new patients

Locations

3795 Mansell Rd
Alpharetta, GA 30022
Phone (404) 785-8540

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

2174 N Druid Hills Rd NE
Brookhaven, GA 30329
Phone (404) 785-7856

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1003340472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2174 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2174 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293102",
            "telephone_number": "404-785-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Burnet Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "45229",
            "country_code": "US",
            "telephone_number": "513-636-4531",
            "fax_number": "513-636-7407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 S Preston St Rm 305",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021702",
            "country_code": "US",
            "telephone_number": "502-852-8696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2174 N Druid Hills Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303293102",
            "country_code": "US",
            "telephone_number": "404-785-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "JACOB",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "GA",
            "license": "105633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.