Dr. Roger L. Humphreys

Primary specialty

DentistTaxonomy code 122300000X

License

4471 Issued in CO

Legal business name

DR. ROGER L. HUMPHREYS

Practice address

415 W Rockrimmon Blvd Ste 200
Colorado Springs, CO 80919-1773

Phone

(719) 599-5340

Fax

(719) 598-0275

NPI assigned

Apr 3, 2013

Last updated

Apr 3, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Denise G. Garcia

Title

Office Manager

Phone

(719) 599-5340

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1215270756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W ROCKRIMMON BLVD STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809191773",
            "telephone_number": "719-599-5340",
            "fax_number": "719-598-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W ROCKRIMMON BLVD STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809191773",
            "telephone_number": "719-599-5340",
            "fax_number": "719-598-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ROGER L. HUMPHREYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "719-599-5340",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "4471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.