Individual provider Active NPI

Kristin Elizabeth Humphreys, MD

  • Internal Medicine Physician
  • Overland Park, KS
National Provider Identifier
1174596803
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-34763 Issued in KS
Practice address
4061 Indian Creek Pkwy
Overland Park, KS 66207-4030
Phone
(913) 323-4600
Fax
(913) 323-4748
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2010024517 MO
Internal Medicine Physician 207R00000X 04-34763 KS Primary

Addresses

Primary practice location

4061 Indian Creek Pkwy
Overland Park, KS 66207-4030

Mailing address

901 E. 104TH St
Mailstop 400N
Kansas City, MO 64131
Phone (816) 502-7104

Other practice location 1

1010 Carondelet Drive
Suite 224
Kansas City, MO 64114
Phone (816) 943-0706

Other identifiers 1

IdentifierTypeStateIssuer
101386288MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20120424000461 KS Practitioner - Internal Medicine 2163327529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Pennsylvania State University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1001 6TH Ave
Leavenworth, KS 66048-3248

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

12330 Metcalf Ave
Overland Park, KS 66213-1324

2600 Compass Rd
Glenview, IL 60026-8001

4061 Indian Creek Pkwy
Overland Park, KS 66207-4030
Phone (816) 932-4630

Hospital & facility affiliations

  • Saint Lukes Home Care Home health agency, Kansas City, MO, CCN 267195
  • St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138
  • Saint Luke'S South Hospital Hospital, Overland Park, KS, CCN 170185
  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
  • Saint Luke'S East Hospital Hospital, Lees Summit, MO, CCN 260216
  • Menorah Medical Center Hospital, Overland Park, KS, CCN 170182

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-34763KSMDInternal Medicine Physician
2010024517MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc Internal Medicine CurrentSince Dec 1, 2017 Accepting new patients

Locations

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

4061 Indian Creek Pkwy
Ste 200
Overland Park, KS 66207
Phone (913) 317-7990

4061 Indian Creek Pkwy
Overland Park, KS 66207
Phone (913) 323-4600

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

901 E 104th St
#400N
Kansas City, MO 64131
Phone (816) 502-8756

Interoperability endpoints

  • Direct secure messaging: khumphreys99092@direct.saint-lukes.org

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 9

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1174596803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E. 104TH ST",
            "address_2": "MAILSTOP 400N",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-502-7104",
            "fax_number": "816-932-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 INDIAN CREEK PKWY",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662074030",
            "telephone_number": "913-323-4600",
            "fax_number": "913-323-4748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Carondelet Drive",
            "address_2": "Suite 224",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "64114",
            "country_code": "US",
            "telephone_number": "816-943-0706",
            "fax_number": "816-943-6122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "KRISTIN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2010024517",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-34763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101386288",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.