Individual provider Active NPI

Jessica Humphrey, PT, DPT, OCS

  • Physical Therapist
  • Tacoma, WA
National Provider Identifier
1346729563
Registry record updated Apr 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61051447 Issued in WA
Practice address
9040 Jackson Ave
Tacoma, WA 98431-2192
Phone
(253) 968-2252
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CA
Physical Therapist 225100000X PT61051447 WA Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-2192

Mailing address

1007 39TH Ave SE
Puyallup, WA 98374-2192
Phone (253) 435-3100

Other practice location 1

1007 39th Ave SE
Puyallup, WA 98374-2192
Phone (253) 435-3100

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT61051447WAMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: jhumphrey453766@ghc.direct-ci.net

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649462400000",
    "number": "1346729563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 39TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742192",
            "telephone_number": "253-435-3100",
            "fax_number": "253-435-3138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984312192",
            "telephone_number": "253-968-2252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 39th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983742192",
            "country_code": "US",
            "telephone_number": "253-435-3100",
            "fax_number": "253-435-3138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "JESSICA",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2022-04-09",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61051447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1007 39th Ave SE",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983742192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.