Russell Shannon Humphries, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH3773 Issued in FL

Practice address

4343 Ridgewood Avenue
Suite B
Port Orange, FL 32127

Phone

(386) 767-2727

Fax

(386) 767-6674

NPI assigned

Jul 28, 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

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Russell S. Humphries, D.C.

  • Chiropractor
  • Port Orange, FL
  • NPI 1215702931
  NPD Authorized official

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497769210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 RIDGEWOOD AVENUE",
            "address_2": "SUITE B",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "32127",
            "telephone_number": "386-767-2727",
            "fax_number": "386-767-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 RIDGEWOOD AVENUE",
            "address_2": "SUITE B",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "32127",
            "telephone_number": "386-767-2727",
            "fax_number": "386-767-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHRIES",
        "first_name": "RUSSELL",
        "middle_name": "SHANNON",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH3773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Hudkins
• Mallory Huff
• Ashley Michelle Hughes, D.C.
• Mikala Patricia Hughes
• John Wesley Humbert, D.C.
• Patricia E. Hunter, PSYD
• Aaron Hutchinson, AU.D.
• Joan Margaret Hutchison
• Mindy Erin Hutfilz
• Jordon Hutson

• Chiropractor in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Chiropractor in Florida

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.