Individual provider Active NPI

Amy Fanning Humphrey, DPT

  • Pediatric Physical Therapist
  • Brighton, MI
National Provider Identifier
1124373444
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
5501017764 Issued in MI
Practice address
7500 Challis Road
Brighton, MI 46116
Phone
(810) 263-4000
NPI assigned
Jul 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 5501017764 MI Primary

Addresses

Primary practice location

7500 Challis Road
Brighton, MI 46116

Mailing address

4565 Filbert Dr
Brighton, MI 48116-3703
Phone (614) 657-3114

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
5501017764MIMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1124373444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4565 FILBERT DR",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481163703",
            "telephone_number": "614-657-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 CHALLIS ROAD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "46116",
            "telephone_number": "810-263-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "AMY",
        "middle_name": "FANNING",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MI",
            "license": "5501017764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.