Individual provider Active NPI

Jordan Humphrey, M.D.

  • Emergency Medicine Physician
  • Chapel Hill, NC
National Provider Identifier
1114347952
Registry record updated May 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2015-01744 Issued in NC
Practice address
170 Manning Dr CB 7594
Chapel Hill, NC 27599-2360
Phone
(919) 966-6440
NPI assigned
Apr 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2015-01744 NC Primary

Addresses

Primary practice location

170 Manning Dr CB 7594
Chapel Hill, NC 27599-2360

Mailing address

170 Manning Dr CB 7594
Chapel Hill, NC 27599-2360
Phone (919) 966-6440

Other practice location 1

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-6995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230608001011 NC Practitioner - Emergency Medicine 5092146373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Pennsylvania State University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Emergency Physicians PAGroup PAC ID 9931002078, 269 clinicians

Practice addresses (Care Compare)

509 N Brightleaf Blvd
Smithfield, NC 27577-4407
Phone (919) 934-8171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
75.66
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015-01744NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Emergency Physicians PA Emergency Medicine CurrentSince Jul 15, 2023 Accepting new patients
Wake Emergency Physicians PA Emergency Medicine CurrentSince Jul 15, 2023 Accepting new patients
Wake Emergency Physicians PA Emergency Medicine Current Accepting new patients

Locations

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

509 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 934-8171

Interoperability endpoints

  • Direct secure messaging: jhumphrey306412@directhisp.wakemed.org

Organizations & group practices 3

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 3

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": "1397952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589673600000",
    "number": "1114347952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MANNING DR CB 7594",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275992360",
            "telephone_number": "919-966-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MANNING DR CB 7594",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275992360",
            "telephone_number": "919-966-6440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-6995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "JORDAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-20",
        "last_updated": "2020-05-17",
        "certification_date": "2020-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2015-01744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.