Tricia Dudek Humphrey, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

40152 Issued in SC

Practice address

1483 Tobias Gadson Blvd Ste 109
Charleston, SC 29407-4795

Phone

(843) 556-8110

Fax

(843) 556-8112

NPI assigned

Mar 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thumphrey1251632@direct.bsmhealth.org

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.

• Coastal Pediatric Associates, P.a.

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1770700759
  Medicare reassignment NPD
• Parkwood Pediatric Group PA

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1659521201
  NPD (past)

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673740800000",
    "number": "1073812731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1483 TOBIAS GADSON BLVD STE 109",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074795",
            "telephone_number": "843-556-8110",
            "fax_number": "843-556-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1483 TOBIAS GADSON BLVD STE 109",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074795",
            "telephone_number": "843-556-8110",
            "fax_number": "843-556-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "TRICIA",
        "middle_name": "DUDEK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-21",
        "last_updated": "2023-01-15",
        "certification_date": "2023-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P7427",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "40152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401522",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Thomas Hulvey Jr., M.D.
• Alaa Hulwe
• Elizabeth Mary Humanitzki, OTR/L
• Heather Hummel, PHARMD
• Sophia Barree Humphrey
• Kate Wallace Humphries, MS, CCC-SLO
• Kara Blevens Huncik, M.D.
• Cynthia Anne Hund
• Tamatha M Huneycutt, NNP
• John Phillips Hungerford, M.D.

• Pediatrics Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.