Individual provider Active NPI

Emily Rose Humphreys

  • Student in an Organized Health Care Education/Training Program
  • West Roxbury, MA
National Provider Identifier
1447789417
Registry record updated Jun 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1400 VFW Pkwy
West Roxbury, MA 02132-4927
Phone
(715) 579-1453
Fax
(715) 579-1453
NPI assigned
Jun 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1400 VFW Pkwy
West Roxbury, MA 02132-4927

Mailing address

1400 VFW Pkwy
West Roxbury, MA 02132-4927
Phone (715) 579-1453

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180809005167 MA Practitioner - Optometry 4587912308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn Community Health, Inc.Group PAC ID 0042217507, 95 clinicians

Practice addresses (Care Compare)

20 Central Ave
Lynn, MA 01901-1314

269 Union St
Lynn, MA 01901-1314
Phone (959) 216-7305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5273MAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn Community Health, Inc. CurrentSince Jul 2, 2018 Accepting new patients

Locations

280 Union St
Ste 202
Lynn, MA 01901
Phone (781) 780-4555

20 Central Ave
Fl 1
Lynn, MA 01901
Phone (540) 834-3295

269 Union St
Lynn, MA 01901
Phone (781) 581-9832

Interoperability endpoints

  • Direct secure messaging: ehumphreys234836@direct.ochin.org

Organizations & group practices 1

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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496620800000",
    "number": "1447789417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021324927",
            "telephone_number": "715-579-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021324927",
            "telephone_number": "715-579-1453",
            "fax_number": "715-579-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "EMILY",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

Verify at the official NPI Registry.