Individual provider Active NPI

Robert Bryan Humphreys, LCSW, ACSW

  • Clinical Social Worker
  • Chattanooga, TN
National Provider Identifier
1356401129
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4837 Issued in TN
Practice address
5600 Brainerd Rd Ste A4
Chattanooga, TN 37411-5336
Phone
(423) 266-4588
Fax
(865) 342-0103
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4837 TN Primary

Addresses

Primary practice location

5600 Brainerd Rd Ste A4
Chattanooga, TN 37411-5336

Mailing address

1923 Sulphur Springs Rd
Morristown, TN 37813-5654
Phone (423) 317-9344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120319000282 TN Practitioner - Clinical Social Worker 7315033057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Tennessee, HSC, College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee Health SystemsGroup PAC ID 3577474295, 128 clinicians

Practice addresses (Care Compare)

5600 Brainerd Rd
Chattanooga, TN 37411-5336
Phone (423) 266-4588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Health Systems CurrentSince Jan 8, 2018 Accepting new patients
Cherokee Health Systems CurrentSince Jan 8, 2018 Accepting new patients

Locations

5600 Brainerd Rd
Ste A4
Chattanooga, TN 37411
Phone (423) 266-4588

2018 Western Ave
Knoxville, TN 37921
Phone (865) 544-0406

1923 Sulphur Springs Rd
Morristown, TN 37813

6350 W Andrew Johnson Hwy
Talbott, TN 37877
Phone (423) 586-5031

6350 W Andrew Johnson Hwy
#100
Talbott, TN 37877
Phone (423) 586-5031

Interoperability endpoints

  • Direct secure messaging: robert.humphreys.p1@direct.cherokeehealth.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1356401129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SULPHUR SPRINGS RD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135654",
            "telephone_number": "423-317-9344",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 BRAINERD RD STE A4",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374115336",
            "telephone_number": "423-266-4588",
            "fax_number": "865-342-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "ROBERT",
        "middle_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "LCSW, ACSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "4837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.