Active NPI
Tara D Humphreys, LAT, ATC
- Sports Medicine (Orthopaedic Surgery) Physician
- Shelbyville, IN
National Provider Identifier
1467822320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 36001308A
- Practice address
- 275 W Bassett Rd
Shelbyville, IN 46176-8574 - Phone
- (317) 392-2161
- Fax
- (317) 398-1870
- NPI assigned
- Oct 3, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 36001308A | IN | Primary |
Addresses
Primary practice location
275 W Bassett Rd
Shelbyville, IN 46176-8574
Mailing address
12345 E Legal Tender Rd
Columbus, IN 47203-9424
Phone (812) 350-7495
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36001308A | IN | MD | Sports Medicine (Orthopaedic Surgery) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443830400000",
"number": "1467822320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12345 E LEGAL TENDER RD",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472039424",
"telephone_number": "812-350-7495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 W BASSETT RD",
"city": "SHELBYVILLE",
"state": "IN",
"postal_code": "461768574",
"telephone_number": "317-392-2161",
"fax_number": "317-398-1870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMPHREYS",
"first_name": "TARA",
"middle_name": "D",
"name_prefix": "Mrs.",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-03",
"last_updated": "2015-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "IN",
"license": "36001308A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelbyville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.