William T Humphrey Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

67918 Issued in MN

Practice address

309 Holly LN
Mankato, MN 56001-5422

Phone

(507) 388-2120

Fax

(507) 388-3924

NPI assigned

Oct 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, WA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: whumphrey1188943@wm.providencedirect.org

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.

• Healogics Specialty Physicians of Georgia, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Columbus, GA
  • NPI 1265843536
  Medicare reassignment NPD
• Okanogan County Public Hospital Dist No 4

  • Critical Access Hospital
  • Tonasket, WA
  • NPI 1164580700
  Medicare reassignment NPD
• Okanogan County Public Hospital Dist No 4

  • Medical Specialty Clinic/Center
  • Tonasket, WA
  • NPI 1750443834
  Medicare reassignment NPD
• Healogics Specialty Physicians of Georgia, LLC

  • Multi-Specialty Clinic/Center
  • Cumming, GA
  • NPI 1336790468
  NPD
• Okanogan County Public Hospital Dist No 4

  • Rural Health Clinic/Center
  • Tonasket, WA
  • NPI 1811555931
  NPD

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1699765693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 HOLLY LN",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015422",
            "telephone_number": "507-388-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 HOLLY LN",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015422",
            "telephone_number": "507-388-2120",
            "fax_number": "507-388-3924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 S Western Ave",
            "address_purpose": "LOCATION",
            "city": "Tonasket",
            "state": "WA",
            "postal_code": "988558803",
            "country_code": "US",
            "telephone_number": "509-486-2151",
            "fax_number": "509-486-3176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Vernon Rd",
            "address_2": "Suite G",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302404143",
            "country_code": "US",
            "telephone_number": "706-880-7366",
            "fax_number": "706-880-7299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "WILLIAM",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "075631",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60974043",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-8090",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "67918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "humphrey.william@odhc.org",
            "affiliation": "N",
            "endpointDescription": "FQHC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Mankato",
            "address_1": "309 Holly Ln",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560015422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Naomi Nya Hudson
• John R Hughes, MD
• McKayla Lynn Huikko
• Julie Marie Huisken, DNP, MSN,BSN,RN
• Timothy W. Huisken, MD
• Kaitlyn Judith Hunstad
• Christine Hunter, DNP, CPNP-PC
• Kayla Marie Hunter
• Luke Aaron Hunter, MD
• Suzanne Huntsman

• Family Medicine Physician in Mankato, MN
• Providers in Mankato, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.