Organization Active NPI

Vinna Denison Humphries MD LLC

  • Family Medicine Physician
  • Hopkinsville, KY
National Provider Identifier
1720002371
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VINNA DENISON HUMPHRIES MD LLC
Practice address
320 North Dr
Hopkinsville, KY 42240-1806
Phone
(270) 707-0303
Fax
(270) 707-0808
NPI assigned
Jul 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Vinna D Humphries, MD
Title
Owner
Phone
(270) 707-0303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

320 North Dr
Hopkinsville, KY 42240-1806

Mailing address

320 North Dr
Hopkinsville, KY 42240-1806
Phone (270) 707-0303

Other identifiers 1

IdentifierTypeStateIssuer
65938599MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050913000946 KY Part B Supplier - Clinic/Group Practice 6204869050 Receives reassigned benefits from 1 practitioner
Practice locations: Hopkinsville, KY

National Provider Directory

National Provider Directory

Locations

1910 S Virginia St
Ste 105
Hopkinsville, KY 42240
Phone (270) 707-0303

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1720002371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 NORTH DR",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401806",
            "telephone_number": "270-707-0303",
            "fax_number": "270-707-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 NORTH DR",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401806",
            "telephone_number": "270-707-0303",
            "fax_number": "270-707-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINNA DENISON HUMPHRIES MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "HUMPHRIES",
        "authorized_official_first_name": "VINNA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-707-0303",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65938599",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.