Active NPI
Roger Lea Humphrey, M.D.
- Surgery Physician
- Owensboro, KY
National Provider Identifier
1245239292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 19761
- Practice address
- 2801 New Hartford Rd
Owensboro, KY 42303-1320 - Phone
- (270) 683-3720
- Fax
- (270) 686-7331
- NPI assigned
- Jul 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 01046282A | IN | |
| Vascular Surgery Physician | 2086S0129X | 01046282A | IN | |
| Vascular Surgery Physician | 2086S0129X | 19761 | KY | |
| Surgery Physician | 208600000X | 19761 | KY | Primary |
Addresses
Primary practice location
2801 New Hartford Rd
Owensboro, KY 42303-1320
Mailing address
2801 New Hartford Rd
Owensboro, KY 42303-1320
Phone (270) 683-3720
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200132180 | Other | IN | MOLINA |
| 200132180 | Medicaid | IN | |
| 611059472 | Other | KY | DART |
| 64197619 | Medicaid | KY | |
| 6110594722109 | Other | IN | CARESOURCE |
| 000000048413 | Other | KY | ANTHEM |
| 611059472 | Other | UMWA | |
| 020038275 | Other | RAILROAD MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rhumphrey5547@direct.owensborohealth.org | Owensboro Health Medical Group, Inc |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19761 | KY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Owensboro Health Medical Group Inc | Surgery | Current | Accepting new patients |
| Owensboro Health Medical Group, Inc | Surgery | Current | Accepting new patients |
Locations
421 7th St
Tell City, IN 47586
Phone (812) 547-7448
2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351
2801 New Hartford Rd
Owensboro, KY 42303
Phone (270) 683-3720
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.
-
- Surgery Physician
- Greenville, KY
- NPI 1235518242
-
- Surgery Physician
- Owensboro, KY
- NPI 1346582194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1245239292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 NEW HARTFORD RD",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "423031320",
"telephone_number": "270-683-3720",
"fax_number": "270-686-7331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 NEW HARTFORD RD",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "423031320",
"telephone_number": "270-683-3720",
"fax_number": "270-686-7331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMPHREY",
"first_name": "ROGER",
"middle_name": "LEA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-20",
"last_updated": "2023-11-27",
"certification_date": "2020-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IN",
"license": "01046282A",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "IN",
"license": "01046282A",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "KY",
"license": "19761",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "19761",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA",
"identifier": "200132180",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200132180",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DART",
"identifier": "611059472",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64197619",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE",
"identifier": "6110594722109",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000048413",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA",
"identifier": "611059472",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "020038275",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rhumphrey5547@direct.owensborohealth.org",
"affiliation": "Y",
"affiliationName": "Owensboro Health Medical Group, Inc",
"address_1": "2801 New Hartford Rd",
"city": "Owensboro",
"state": "KY",
"country_code": "US",
"postal_code": "423031320",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Owensboro, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.