Timothy A Humphries, MD

Primary specialty

Trauma Surgery PhysicianTaxonomy code 2086S0127X

License

53641 Issued in GA

Practice address

100 Doctors Dr Ste C
Douglas, GA 31533-2211

Phone

(912) 384-5832

Fax

(912) 383-8279

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

General Surgery

Education

Medical College of Georgia School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CRH Physician Practices, LLCGroup PAC ID 5193727964, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Coffee Regional Medical Center, Inc Hospital, Douglas, GA, CCN 110089

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothy.humphries.p47@direct.tenet.nextgenshare.com
• Direct secure messaging: timothy.humphries.p53@direct.tenet.nextgenshare.com
• Direct secure messaging: timothy.humphries.1@9964.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 and National Provider Directory roles.

• CRH Physician Practices, LLC

  • Multi-Specialty Clinic/Center
  • Douglas, GA
  • NPI 1710046073
  Medicare reassignment Care Compare group
• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212

  Surgery

  Medicare reassignment NPD
• Savannah Thoracic and Vascular Surgery, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Savannah, GA
  • NPI 1700830528
  NPD (past) Authorized official
• CRH Physician Practices LLC

  • Surgery Physician
  • Waycross, GA
  • NPI 1154794857
  NPD (past)

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

• Coffee Regional Medical Center, Inc

  • General Acute Care Hospital
  • Douglas, GA
  • NPI 1760419527
  Care Compare affiliation

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1689625162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1377",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315341377",
            "telephone_number": "912-384-1477",
            "fax_number": "912-384-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DOCTORS DR STE C",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332211",
            "telephone_number": "912-384-5832",
            "fax_number": "912-383-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHRIES",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "053461",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "GA",
            "license": "53641",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "GA",
            "license": "53641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "715822455",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Delaine Hodge, PA-C
• Julie Holden, SLP
• James Andrew Holt, PHARM D, RPH
• Hospice Care Options Inc
• Joshua Hughes, ANP-BC
• Shaista Hussain, M.D.
• Amie Lee Hutcheson
• Lindsay M Hutcheson, M ED CCC/SLP
• Larry Hutchison, D.C.
• I V Care of Middle Georgia Inc

• Trauma Surgery Physician in Douglas, GA
• Providers in Douglas, GA by specialty
• Trauma Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.