Gregory T. Humphreys, P.T.
Individual provider Active NPI Physical Therapist · Ranson, WV
NPI 1255418562 · NPPES record last updated Jul 21, 2015
Key facts
- NPI
- 1255418562
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 000269 (WV)
- Practice address
- 112 S Reymann St
Ranson, WV 25438-1730 - Phone
- (304) 725-3632
- Fax
- (304) 725-8252
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00269 | WV | MD | Specialist |
| 269 | WV | MD | Podiatrist |
| 2305001499 | VA | MD | Physical Therapist |
| 000269 | WV | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Winchester Physical Therapy & Sports Medicine, Inc. | Specialist | Past |
Accepting new patients |
Interoperability endpoints
- gregory.humphreys.p1@direct.winc-ortho.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 00269 | WV | |
| Orthopedic Physical Therapist | 2251X0800X | 2305001499 | VA | |
| Physical Therapist | 225100000X | 000269 | WV | Yes |
| Physical Therapist | 225100000X | 2305001499 | VA |
Addresses
Primary practice location
112 S Reymann St
Ranson, WV 25438-1730
Mailing address
PO Box 2217
Winchester, VA 22604-1417
Phone (540) 667-8975
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0156637000 | Medicaid | WV | |
| 3810004945 | Medicaid | VA |
Other providers in Ranson, WV
- Ashley Helsley
- Autumn N Hite
- Kelly Hite
- Tasia Ann Holmes
- Stephanie Melissa Hoyle
- Ronald Gene Hutson
- Independent Fire Company No. 1 of Charles Town West Virginia
- Eric Ingersoll
- Inhome Medications WV, Inc
- Inhome Medications WV, Inc
All providers in Ranson, WV · Physical Therapist in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.