NPIMap

Individual provider Active NPI

Michelle E Humphreys

  • Women's Health Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1124128905
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
41918 Issued in WV
Practice address
830 Pennsylvania Ave
Suite 304
Charleston, WV 25302
Phone
(304) 388-1515
Fax
(304) 388-1570
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 41918 WV Primary

Addresses

Primary practice location

830 Pennsylvania Ave
Suite 304
Charleston, WV 25302

Mailing address

PO Box 7000
Morgantown, WV 26507-7000
Phone (304) 347-1290

Other identifiers 1

IdentifierTypeStateIssuer
3810003794MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000311 WV Practitioner - Nurse Practitioner 1254350614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

830 Pennsylvania Ave
Suite 304
Charleston, WV 25302-3390
Phone (304) 388-1515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
41918WVMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Apr 18, 2022 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Apr 18, 2022 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Womencare, Inc Past Accepting new patients

Locations

3200 Maccorkle Ave SE
#C
Charleston, WV 25304
Phone (304) 347-1336

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

830 Pennsylvania Ave
Ste 304
Charleston, WV 25302
Phone (304) 388-1515

1401 Hospital Dr
Ste 302
Hurricane, WV 25526
Phone (304) 351-1551

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 12

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124128905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7000",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265077000",
            "telephone_number": "304-347-1290",
            "fax_number": "304-347-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 PENNSYLVANIA AVE",
            "address_2": "SUITE 304",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25302",
            "telephone_number": "304-388-1515",
            "fax_number": "304-388-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "MICHELLE",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WV",
            "license": "41918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003794",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.