Active NPI
Brian D. Humphrey, AT, ATC
- Specialist
- Mount Vernon, OH
National Provider Identifier
1508801796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- AT-1028
- Practice address
- 800 Martinsburg Road Physical Education and Athletics
Mount Vernon Nazarene University
Mount Vernon, OH 43050 - Phone
- (740) 397-9000
- NPI assigned
- Jun 19, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | AT-1028 | OH | Primary |
Addresses
Primary practice location
800 Martinsburg Road Physical Education and Athletics
Mount Vernon Nazarene University
Mount Vernon, OH 43050
Mailing address
38 Hilltop Dr
Mount Vernon, OH 43050-1841
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 |
|---|---|---|---|
| AT-1028 | OH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427241600000",
"number": "1508801796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 HILLTOP DR",
"city": "MOUNT VERNON",
"state": "OH",
"postal_code": "430501841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 MARTINSBURG ROAD PHYSICAL EDUCATION AND ATHLETICS",
"address_2": "MOUNT VERNON NAZARENE UNIVERSITY",
"city": "MOUNT VERNON",
"state": "OH",
"postal_code": "43050",
"telephone_number": "740-397-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMPHREY",
"first_name": "BRIAN",
"middle_name": "D.",
"name_prefix": "Mr.",
"credential": "AT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-19",
"last_updated": "2015-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "AT-1028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.