Individual provider Active NPI

Thomas M Humber, D.C.

  • Chiropractor
  • Sharpsburg, GA
National Provider Identifier
1396964565
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR001202 Issued in GA
Practice address
820 Ebenezer Church Rd
Suite 100
Sharpsburg, GA 30277-2073
Phone
(770) 251-4345
Fax
(770) 251-8072
NPI assigned
Apr 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH2813 FL
Chiropractor 111N00000X CHIR001202 GA Primary

Addresses

Primary practice location

820 Ebenezer Church Rd
Suite 100
Sharpsburg, GA 30277-2073

Mailing address

820 Ebenezer Church Rd
Suite 100
Sharpsburg, GA 30277-2073
Phone (770) 251-4345

Other identifiers 1

IdentifierTypeStateIssuer
145745OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111208000376 GA Practitioner - Chiropractic 3072579812 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1202GAMDClinical Social Worker
CH2813FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Humber-Kirk Chiropractic Clinic, LLC Chiropractor CurrentSince Jan 1, 2002 Accepting new patients
Humber-Kirk Chiropractic Clinic, LLC Chiropractor CurrentSince Jan 1, 2002 Accepting new patients

Locations

820 Ebenezer Church Rd
Ste 100
Sharpsburg, GA 30277
Phone (770) 251-4345

190 Handley Rd
Ste B
Tyrone, GA 30290
Phone (404) 768-8008

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396964565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 EBENEZER CHURCH RD",
            "address_2": "SUITE 100",
            "city": "SHARPSBURG",
            "state": "GA",
            "postal_code": "302772073",
            "telephone_number": "770-251-4345",
            "fax_number": "770-251-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 EBENEZER CHURCH RD",
            "address_2": "SUITE 100",
            "city": "SHARPSBURG",
            "state": "GA",
            "postal_code": "302772073",
            "telephone_number": "770-251-4345",
            "fax_number": "770-251-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMBER",
        "first_name": "THOMAS",
        "middle_name": "M",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH2813",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR001202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "145745",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sharpsburg, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.