Kallie Blythe Humphreys, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2188 Issued in OK

Practice address

3300 NW Expressway
Oklahoma City, OK 73112-4999

Phone

(405) 949-3011

NPI assigned

Dec 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khumphreys399977@direct-ehr-ssmhc.com

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.

• Emergency Physicians of Mid-America, P.C.

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1063825297
  Medicare reassignment
• Emergency Physicians of Midwest City, LLC

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1558386474
  Medicare reassignment
• Integris Ambulatory Care Corporation

  dba INTEGRIS Medical Group

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  Medicare reassignment
• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment
• Mercy Oklahoma Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Moore, OK
  • NPI 1922509173
  Medicare reassignment
• Ou Health Partners, Inc

  dba OUHP Orthotics & Prosthetic

  • Prosthetic/Orthotic Supplier
  • Oklahoma City, OK
  • NPI 1447834460
  NPD
• Mercy Hospital Oklahoma City, Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1184721722
  NPD (past)
• Questcare Em Oklahoma LLC

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1427391481
  NPD (past)
• SSM Health Care of Oklahoma, Inc

  • General Acute Care Hospital
  • Midwest City, OK
  • NPI 1700471497
  NPD (past)

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1194061143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269032",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731269032",
            "telephone_number": "405-951-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NW EXPRESSWAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124999",
            "telephone_number": "405-949-3011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2825 Parklawn Dr",
            "address_purpose": "LOCATION",
            "city": "Midwest City",
            "state": "OK",
            "postal_code": "731104201",
            "country_code": "US",
            "telephone_number": "405-610-4411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "KALLIE",
        "middle_name": "BLYTHE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "APA2188",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Humphrey, DPH
• Mary Beth Humphrey, M.D., PH.D.
• Ona M Humphrey
• Taylor Humphrey
• Kacey Humphreys
• Madison Skye Humphreys
• Michael Ward Humphries, M.S., CCC-SLP, BCBA
• Sharon Ann Humphries, MSW LCSW
• Robin Humrich, MD
• Rachel Nicole Hundley, BS

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.