Individual provider Active NPI

D'Andra Humphrey, FNP

  • Family Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1154797223
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP08374 Issued in LA
Practice address
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 675-5087
NPI assigned
Aug 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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 AP08374 LA Primary

Addresses

Primary practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171204002879 TX Practitioner - Nurse Practitioner 5193034999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lonestar Hospital Medicine Associates PAGroup PAC ID 6709049703, 126 clinicians

Practice addresses (Care Compare)

3500 W Wheatland Rd
Dallas, TX 75237-3460
Phone (214) 947-7777

Hospital & facility affiliations

  • Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lonestar Hospital Medicine Associates, PA CurrentSince Dec 15, 2017 Accepting new patients
Revive Community Health Family CurrentSince Nov 5, 2025 Accepting new patients

Locations

4700 S McClintock Dr
Ste 140
Tempe, AZ 85282
Phone (480) 420-6622

6210 Campbell Rd
Ste 225
Dallas, TX 75248
Phone (480) 851-6309

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

1201 E Highway 287
Midlothian, TX 76065
Phone (469) 695-2065

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

Organizations & group practices 2

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 1

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": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1154797223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "D'ANDRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.