Justin Edward Humphrey, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

LL52041 Issued in SC

Practice address

Internal Medicine Clinic
1801 Sunset Drive
Columbia, SC 29203

Phone

(803) 434-4153

Fax

(803) 434-4160

NPI assigned

Jun 19, 2018

Last updated

Jun 19, 2018By 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

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Lincoln Memorial University Medical Department, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Medicine Services of Tennessee PCGroup PAC ID 9234432881, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Covenant Homecare Home health agency, Knoxville, TN, CCN 447139
• Fort Loudoun Medical Center Hospital, Lenoir City, TN, CCN 440110
• Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jhumphrey@yourcarecommunity.org

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 Medicine Services of Tennessee PC

  • Hospitalist Physician
  • Lawrenceburg, IN
  • NPI 1528433802

  Internal Medicine, TN

  Medicare reassignment Care Compare group NPD
• Saint Thomas Medical Partners

  dba Ascension Medical Group Saint Thomas

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1437194669
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Covenant Homecare

  • Home Health Agency
  • Knoxville, TN
  • NPI 1982690640
  Care Compare affiliation
• Fort Loudoun Medical Center

  • General Acute Care Hospital
  • Lenoir City, TN
  • NPI 1609860659
  Care Compare affiliation
• Parkwest Medical Center

  dba Peninsula Div Parkwest MC

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165
  Care Compare affiliation

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1285128660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "INTERNAL MEDICINE CLINIC",
            "address_2": "1801 SUNSET DRIVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-4153",
            "fax_number": "803-434-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INTERNAL MEDICINE CLINIC",
            "address_2": "1801 SUNSET DRIVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-4153",
            "fax_number": "803-434-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "JUSTIN",
        "middle_name": "EDWARD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL52041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Human Performance and Rehabilitation Centers, LLC
• Human Resource Development, Inc.
• Humana Benefit Plan of South Carolina, Inc.
• Kayla Humenansky, DO
• Albert Humphrey, MD
• Marissa Alauna Humphrey
• Stephen Harmes Humphrey, M.D.
• Reghan Humphreys, LAT, ATC
• Stacey Michelle Humphreys, M.D
• Alyssa Denise Humphries, RN, IBCLC

• Internal Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.