NPIMap

Individual provider Active NPI

Craig S Humes, PA

  • Physician Assistant
  • Mt Pleasant, UT
National Provider Identifier
1528013166
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1018291206 Issued in UT
Practice address
1100 S Medical Dr
Mt Pleasant, UT 84647-2222
Phone
(435) 462-2441
Fax
(435) 462-2609
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1018291206 UT Primary

Addresses

Primary practice location

1100 S Medical Dr
Mt Pleasant, UT 84647-2222

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180
Phone (801) 357-7475

Other identifiers 1

IdentifierTypeStateIssuer
807932900MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031117000700 UT Practitioner - Physician Assistant 8426962192 Reassigns benefits to 1 organization
I20240918001035 NE Practitioner - Physician Assistant 8426962192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sterling Provider Group 52 clinicians

Practice addresses (Care Compare)

630 E 1400
Suite 150
Logan, UT 84341-2549
Phone (435) 915-4465

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1018291206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Provider Group CurrentSince Mar 3, 2025 Accepting new patients
Sterling Provider Group CurrentSince Mar 3, 2025 Accepting new patients
North Platte Nebraska Hospital Corporation CurrentSince Jul 22, 2024 Accepting new patients
Strata Medical LLC Past Accepting new patients
Page Hospital Past Accepting new patients

Locations

740 S Woodruff Ave
Idaho Falls, ID 83401
Phone (208) 542-9111

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

630 E 1400 N
Ste 150
North Logan, UT 84341
Phone (435) 787-8504

Interoperability endpoints

  • Direct secure messaging: chumes481916@direct.nebraskamed.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1528013166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180",
            "telephone_number": "801-357-7475",
            "fax_number": "801-357-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S MEDICAL DR",
            "city": "MT PLEASANT",
            "state": "UT",
            "postal_code": "846472222",
            "telephone_number": "435-462-2441",
            "fax_number": "435-462-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMES",
        "first_name": "CRAIG",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "1018291206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807932900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, UT

Sources for this page

Verify at the official NPI Registry.