Individual provider Active NPI

William Scott Humphrey, MD

  • Family Medicine Physician
  • Zeeland, MI
National Provider Identifier
1164912218
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301503091 Issued in MI
Practice address
400 S State St Ste 250
Zeeland, MI 49464-2092
Phone
(616) 741-2364
Fax
(616) 741-2367
NPI assigned
May 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301503091 MI Primary

Addresses

Primary practice location

400 S State St Ste 250
Zeeland, MI 49464-2092

Mailing address

400 S State St Ste 250
Zeeland, MI 49464-2092
Phone (616) 741-2364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180531003034 MI Order and Referring Only - Family PracticePractitioner - Family Practice 5799040374

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301503091MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Co. CurrentSince Jul 16, 2023 Accepting new patients

Locations

400 S State St
Ste 250
Zeeland, MI 49464
Phone (616) 741-2364

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1164912218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S STATE ST STE 250",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494642092",
            "telephone_number": "616-741-2364",
            "fax_number": "616-741-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S STATE ST STE 250",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494642092",
            "telephone_number": "616-741-2364",
            "fax_number": "616-741-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-15",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301503091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zeeland, MI

Sources for this page

Verify at the official NPI Registry.