Edwin Jacob Humphrey IV, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

ME0051812 Issued in FL

Practice address

701 6TH St S
St Petersburg, FL 33701-4814

Phone

(727) 893-6182

Fax

(727) 893-6861

NPI assigned

Jul 18, 2006

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

Enrolled in FL

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

Pathology

Education

JC Edwards School of Medicine, Marshall University, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: ehumphrey189315@orlandohealth.medalliesdirect.net

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.

• Ohi West Medical Group, LLC

  • Cardiovascular Disease Physician
  • St Petersburg, FL
  • NPI 1518572551
  Medicare reassignment Care Compare group NPD
• Ohi West Medical Group, LLC

  • Radiology Clinic/Center
  • St Petersburg, FL
  • NPI 1285240192
  NPD
• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  NPD

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

• Ohi West, Inc

  • General Acute Care Hospital
  • St Petersburg, FL
  • NPI 1154399749
  Care Compare affiliation

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1295754547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014814",
            "telephone_number": "727-893-6182",
            "fax_number": "727-893-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014814",
            "telephone_number": "727-893-6182",
            "fax_number": "727-893-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "EDWIN",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME0051812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054869300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Therese M. Hulme, ARNP
• Humble Hydrations Mental Wellness & Growth, LLC.
• Bailey Hummel
• Katie Dorothy Hummel
• Olivia Grace Humpel, DO, MPH
• Tyra Lynn Humphrey, LCSW
• Jan S Humphreys, ARNP-C
• Andrea Sue Hunsinger, MA; CCC/SLP
• Christen Hunt, APRN
• Kadijah Chontae Hunt, HAIR LOSS SPECIALIST

• Anatomic Pathology & Clinical Pathology Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.