Active NPI
Carol Humphry, M.D.
- Family Medicine Physician
- Bethel, AK
National Provider Identifier
1326029257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G75480
- Practice address
- 528 Chief Eddie Hoffman Hwy
Bethel, AK 99559 - Phone
- (907) 543-6300
- NPI assigned
- Nov 8, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G75480 | CA | Primary |
Addresses
Primary practice location
528 Chief Eddie Hoffman Hwy
Bethel, AK 99559
Mailing address
808 SE Chkalov Dr
Ste. 3 - 165
Vancouver, WA 98683
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G75480 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1326029257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 SE CHKALOV DR",
"address_2": "STE. 3 - 165",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "528 CHIEF EDDIE HOFFMAN HWY",
"city": "BETHEL",
"state": "AK",
"postal_code": "99559",
"telephone_number": "907-543-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMPHRY",
"first_name": "CAROL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-08",
"last_updated": "2024-11-12",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G75480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethel, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.