Individual provider Active NPI

Michelle Elaine Castro Humphries, FNP-BC

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1104509785
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0998953 Issued in CO
Practice address
4880 Poleplant Dr
Colorado Springs, CO 80918-5251
Phone
(719) 654-6890
NPI assigned
Aug 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0998953 CO Primary

Addresses

Primary practice location

4880 Poleplant Dr
Colorado Springs, CO 80918-5251

Mailing address

4880 Poleplant Dr
Colorado Springs, CO 80918-5251
Phone (719) 654-6890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0998953COMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1104509785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4880 POLEPLANT DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185251",
            "telephone_number": "719-654-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 POLEPLANT DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185251",
            "telephone_number": "719-654-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO HUMPHRIES",
        "first_name": "MICHELLE",
        "middle_name": "ELAINE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0998953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.