Jon O Humphrey, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

67471 Issued in TN

Practice address

305 W Jackson St
Suite 200
Carbondale, IL 62901-1474

Phone

(618) 453-3777

Fax

(618) 453-1102

NPI assigned

Jun 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Family Practice

Education

Southern Illinois University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amg-Livingston LLCGroup PAC ID 1052225760, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Livingston, TN, CCN 447260
• Quality Home Health Home health agency, Jamestown, TN, CCN 447406
• Livingston Regional Hospital Hospital, Livingston, TN, CCN 440187
• Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jon.humphrey.1@25766.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.

• Amg-Livingston LLC

  • Orthopaedic Surgery Physician
  • Livingston, TN
  • NPI 1699869297
  Medicare reassignment Care Compare group NPD
• Amg - Livingston, LLC

  • Hospitalist Physician
  • Livingston, TN
  • NPI 1134581747
  NPD
• Amg - Livingston, LLC

  • Nurse Practitioner
  • Livingston, TN
  • NPI 1902287097

  Family Medicine

  NPD

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

• All Care Plus Inc.

  • Home Health Agency
  • Jamestown, TN
  • NPI 1629073614
  Care Compare affiliation
• Comprehensive Home Healthcare Services LLC

  • Home Health Agency
  • Livingston, TN
  • NPI 1972551752
  Care Compare affiliation
• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  Care Compare affiliation
• Livingston Regional Hospital LLC

  • Rural Acute Care Hospital
  • Livingston, TN
  • NPI 1396760542
  Care Compare affiliation

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1699972893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "address_2": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-7578",
            "fax_number": "217-545-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST",
            "address_2": "SUITE 200",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-453-3777",
            "fax_number": "618-453-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "JON",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036-116062",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "67471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036116062",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Hudgins, DDS MS
• Lindsay Hudson, LPN
• Elizabeth C Hughes, LCSW
• Lucas Hughes, AAS
• Jamie Hultgren, FNP-BC
• Tramon Hunnicutt
• David Hunt
• Pamela Kay Hunter-Reach, MD
• Long Ha Huynh, M.D., PH.D.
• Michael J. Hyman, M.D.

• Family Medicine Physician in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.