NPIMap

Individual provider Active NPI

Robyn L. Stacy-Humphries, MD

  • Diagnostic Radiology Physician
  • Charlotte, NC
National Provider Identifier
1225021801
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
32964 Issued in NC
Practice address
700 E Morehead St Ste 400
Charlotte, NC 28202-2790
Phone
(704) 334-7800
Fax
(704) 414-7512
NPI assigned
Aug 29, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD28834 SC
Diagnostic Radiology Physician 2085R0202X 32964 NC Primary

Addresses

Primary practice location

700 E Morehead St Ste 400
Charlotte, NC 28202-2790

Mailing address

700 E Morehead St Ste 400
Charlotte, NC 28202-2790
Phone (704) 334-7800

Other identifiers 2

IdentifierTypeStateIssuer
89128VYMedicaidNC
N40033MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100719000312 NC Practitioner - Diagnostic Radiology 0749363141 Reassigns benefits to 2 organizations
I20130228000110 SC Practitioner - Diagnostic Radiology 0749363141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Carolina at Chapel Hill School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Radiology PAGroup PAC ID 4587577390, 222 clinicians
University Cancer and Blood Center LLCGroup PAC ID 0345293866, shared by 2 NPIs, 66 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 362-1945

1656 Riverchase Blvd
Suite 1200
Rock Hill, SC 29732-0270
Phone (803) 327-9934

3320 Old Jefferson Rd
BLDG 700
Athens, GA 30607-1465
Phone (706) 353-2990

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32964NCMDDiagnostic Radiology Physician
MD28834SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Healthcare Medical Group, Inc. Current Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Blue Ridge Healthcare Medical Group Inc Diagnostic Radiology CurrentSince Apr 1, 2020 Accepting new patients
Charlotte Radiology PA Diagnostic Radiology PastSince Jan 1, 2001 Accepting new patients
Blue Ridge Healthcare Medical Group Inc Diagnostic Radiology Past Accepting new patients

Locations

2134 14th Avenue Cir NW
Ste D
Hickory, NC 28601
Phone (828) 580-1236

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225021801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022790",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022790",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACY-HUMPHRIES",
        "first_name": "ROBYN",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "MD28834",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "32964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89128VY",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N40033",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.