Shawn Moreta Humphries, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

06675R Issued in LA

Practice address

200 W 134TH PL
Cut Off, LA 70345-4143

Phone

(985) 632-8256

Fax

(985) 325-8417

NPI assigned

Sep 16, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shawn.humphries.1@748.direct.athenahealth.com

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.

• Lafourche Parish Hospital Service District No.1

  dba Lady of the Sea Physician Group

  • Emergency Medicine Physician
  • Cut Off, LA
  • NPI 1831260793
  Medicare reassignment NPD
• Lafourche Parish Hospital Service District No.1

  dba Lady of the Sea General Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Cut Off, LA
  • NPI 1043358120
  NPD
• Lafourche Parish Hospital Service District No.1

  dba Lady of the Sea General Hospital

  • Critical Access Hospital
  • Cut Off, LA
  • NPI 1922005842
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649376401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 CHATEAU BLVD",
            "address_2": "CONDO C",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700655721",
            "telephone_number": "504-464-7557",
            "fax_number": "985-325-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 134TH PL",
            "city": "CUT OFF",
            "state": "LA",
            "postal_code": "703454143",
            "telephone_number": "985-632-8256",
            "fax_number": "985-325-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHRIES",
        "first_name": "SHAWN",
        "middle_name": "MORETA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "06675R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1355739",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lloyd Joseph Guidry Jr., PHARM.D.
• Rachelle R Guidry, FNP-C
• Health 2000 (LaFourche Chiropractic)
• Lawrence Joseph Hebert III, FNP
• Lauren Holcomb, PHARM, D,
• Heidi Elizabeth Irwin, LCSW
• Kaleidoscope Behavior Services
• Tanner James Lafont, OD
• Lafourche Ambulance District No. 1
• Lafourche Parish Hospital Service District No. 1 (Lady of the Sea Urology Clinic)

• Emergency Medicine Physician in Cut Off, LA
• Providers in Cut Off, LA by specialty
• Emergency Medicine Physician in Louisiana

• 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; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.