Willie James Humphrey, D.D.S.

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

DN0009634 Issued in FL

Practice address

Brevard County Health Department
2575 N Courtney Pkwy
Merritt Island, FL 32953

Phone

(321) 454-7148

Fax

(321) 449-5015

NPI assigned

Dec 15, 2006

Last updated

Dec 12, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Florida Department of Health

  dba Brevard County Health Department

  • Public Health or Welfare Agency
  • Viera, FL
  • NPI 1386751907
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1225190184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BREVARD COUNTY HEALTH DEPARTMENT",
            "address_2": "2575 N COURTNEY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "32953",
            "telephone_number": "321-454-7148",
            "fax_number": "321-449-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BREVARD COUNTY HEALTH DEPARTMENT",
            "address_2": "2575 N COURTNEY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "32953",
            "telephone_number": "321-454-7148",
            "fax_number": "321-449-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "WILLIE",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "DN0009634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077730700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Howard, LPN
• Reva Carol Howard, LPN
• Tonya Howley, FNP-C
• Kristal Ann Huffman, BCBA
• Jaeden Huhta
• Paula Hurd, PHARMD
• Taher Husainy, MD
• Monica Hyder
• Marina Margarita Ianni-Navea, LPN
• Dorothy Dawn Ibasco, APRN

• Public Health Dentistry in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Public Health Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.