Michaela C Humphrey, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0032706 Issued in OH

Practice address

6100 Rockside Woods Blvd N Ste 425
Independence, OH 44131-2340

Phone

(216) 643-2780

Fax

(216) 524-0111

NPI assigned

Dec 12, 2022

Last updated

Dec 12, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Surgical Wound Care IncGroup PAC ID 7416948153, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
• Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
• Pam Health Specialty Hospital of Miamisburg Long-term care hospital, Miamisburg, OH, CCN 362028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Surgical Wound Care, Inc.

  • Surgery Physician
  • Independence, OH
  • NPI 1649215583
  Medicare reassignment Care Compare group NPD
• United Wound & Vascular Institute Ohio PLLC

  • Family Medicine Physician
  • Independence, OH
  • NPI 1477311959
  Medicare reassignment NPD
• Healing Partners Plus PLLC

  • Internal Medicine Physician
  • Naperville, IL
  • NPI 1063217545

  OH

  Medicare reassignment NPD
• Northeast Surgical Associates of Ohio Wound Speciality Services LTD

  • Nurse Practitioner
  • Independence, OH
  • NPI 1073767315
  NPD (past)

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

• Beavercreek Medical Center

  dba Soin Medical Center

  • General Acute Care Hospital
  • Beavercreek, OH
  • NPI 1760764849
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Main Campus

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Miamisburg

  • General Acute Care Hospital
  • Miamisburg, OH
  • NPI 1316966518
  Care Compare affiliation
• Pam Specialty Hospital of Dayton LLC

  dba PAM Health Specialty Hospital of Miamisburg

  • Long Term Care Hospital
  • Miamisburg, OH
  • NPI 1881241636

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1548971575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 ROCKSIDE WOODS BLVD N STE 425",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312340",
            "telephone_number": "216-643-2780",
            "fax_number": "216-524-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 ROCKSIDE WOODS BLVD N STE 425",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312340",
            "telephone_number": "216-643-2780",
            "fax_number": "216-524-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "MICHAELA",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0032706",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0032706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Hubrins
• Shanek Hudson
• Claudette M Hughley
• Kayla Hull
• Humana at Home, Inc. (SeniorBridge)
• Kenya Hunt
• Jennifer Hunte, LISW
• Nicole M Hunter
• I Am Boundless, Inc.
• Jena M Iacco, LPCC-S

• Nurse Practitioner in Independence, OH
• Providers in Independence, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.