Individual provider Active NPI

Coleman Alan Humbert, NP

  • Family Nurse Practitioner
  • Rancho Cordova, CA
National Provider Identifier
1487146213
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95009021 Issued in CA
Practice address
3201 Data Dr
Rancho Cordova, CA 95670-7374
Phone
(916) 851-1440
NPI assigned
Jun 6, 2018
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95009021 CA Primary

Addresses

Primary practice location

3201 Data Dr
Rancho Cordova, CA 95670-7374

Mailing address

3201 Data Dr
Rancho Cordova, CA 95670-7374
Phone (916) 851-1440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181206003419 CA Practitioner - Nurse Practitioner 1850635566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3201 Data Dr
Rancho Cordova, CA 95670-7374
Phone (916) 851-1424

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspace Health CurrentSince Oct 27, 2019 Accepting new patients
Wellspace Health Current Accepting new patients
Wellspace Health CurrentSince Oct 27, 2019 Accepting new patients
Regents of the University of California CurrentSince Sep 20, 2023 Accepting new patients
Regents of the University of California CurrentSince Sep 20, 2023 Accepting new patients
Chest Infectious Diseases & Critical Care Consultants Group Inc PastSince Jul 9, 2023 Accepting new patients
Essent PRMC LP Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

3201 Data Dr
Rncho Cordova, CA 95670
Phone (916) 851-1424

1820 J St
Sacramento, CA 95811
Phone (916) 550-5481

3441 Marysville Blvd
Sacramento, CA 95838
Phone (916) 563-7200

777 12th St
Ste 250
Sacramento, CA 95814
Phone (916) 469-4690

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1487146213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707374",
            "telephone_number": "916-851-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707374",
            "telephone_number": "916-851-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMBERT",
        "first_name": "COLEMAN",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

Verify at the official NPI Registry.