Thomas Randall Humphrey, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001599 Issued in GA

Practice address

1357 Hembree Rd
Suite 250
Roswell, GA 30076-5722

Phone

(770) 475-7550

Fax

(770) 343-9080

NPI assigned

Jun 30, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1164733697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 HEMBREE RD",
            "address_2": "SUITE 250",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765722",
            "telephone_number": "770-475-7550",
            "fax_number": "770-343-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "THOMAS",
        "middle_name": "RANDALL",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "001599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Hughes
• Melissa Sammons Hughes, MD
• Tracey Lyn Huie, MS, ATC/LAT
• Cathleen Hulbert, LCSW
• Karinthian Elaine Hulon, NP
• Laura Lynn Hunter, RN
• Taylor Hunter, RBT
• Jai Huntley, MS
• Saif Husain
• Melissa Hussain, PHARM. D.

• Physician Assistant in Roswell, GA
• Providers in Roswell, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.