Theodore Riggs Humphry, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G33651 Issued in CA

Practice address

1644 Central Ave
McKinleyville, CA 95519-4342

Phone

(707) 839-2677

Fax

(707) 839-2747

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• North Pacific Cardiology Medical

  • Internal Medicine Physician
  • Arcata, CA
  • NPI 1093821837
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1467537415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST",
            "address_2": "SUITE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216248",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 CENTRAL AVE",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955194342",
            "telephone_number": "707-839-2677",
            "fax_number": "707-839-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHRY",
        "first_name": "THEODORE",
        "middle_name": "RIGGS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G33651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G336510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hum Spa
• Humboldt County Behavioral Health
• Humboldt Family Medical Care
• Humboldt Medi-Trans
• Humboldt Pediatric Medical Corporation, Inc.
• Babur Husain
• George Gilbert Husband, MD
• Steven Rene' Hutchinson, RPH
• Scarlet Z Ibis-Roley, IFEC-TMPH, RPF-I
• Innovative ABA Consulting LLC

• Pediatrics Physician in McKinleyville, CA
• Providers in McKinleyville, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.