Individual provider Active NPI

Joel D Humphrey, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Gladwin, MI
National Provider Identifier
1699703637
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
050649 Issued in MI
Practice address
515 Quarter St
Gladwin, MI 48624-1959
Phone
(989) 426-9286
NPI assigned
Jun 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 050649 MI Primary

Addresses

Primary practice location

515 Quarter St
Gladwin, MI 48624-1959

Mailing address

2050 Willow Beach St
Keego Harbor, MI 48320-1210
Phone (248) 342-8025

Other identifiers 1

IdentifierTypeStateIssuer
JH050649OtherMIBLUE SHIELD

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
050649MIMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalmd of Caro Ip, Inc. Past Accepting new patients
Stat Care PC Emergency Medical Services Past Accepting new patients
Chase Dennis Emergency Medical Group Inc Past Accepting new patients
Emcare Physician Providers, Inc Past Accepting new patients
Statcare PC Past Accepting new patients
Obscare PC Past Accepting new patients
Epmg of Michigan, P.C. PastSince Aug 4, 2024 Accepting new patients
Sturgis Emergency Physicians PLLC Past Accepting new patients
Emcare Physician Providers, Inc Past Accepting new patients
Three Rivers Emergency Physicians PLLC Past Accepting new patients

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699703637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 WILLOW BEACH ST",
            "city": "KEEGO HARBOR",
            "state": "MI",
            "postal_code": "483201210",
            "telephone_number": "248-342-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 QUARTER ST",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486241959",
            "telephone_number": "989-426-9286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "JOEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "050649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "JH050649",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladwin, MI

Sources for this page

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

Verify at the official NPI Registry.