Individual provider Active NPI

Kathleen Anne Humphrey, A-NP

  • Adult Health Nurse Practitioner
  • Amherst, NY
National Provider Identifier
1780939199
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
30-306150 Issued in NY
Practice address
144 Walton Dr
Amherst, NY 14226-4832
Phone
(716) 310-6263
NPI assigned
Jul 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 30-306150 NY Primary

Addresses

Primary practice location

144 Walton Dr
Amherst, NY 14226-4832

Mailing address

144 Walton Dr
Amherst, NY 14226-4832
Phone (716) 310-6263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170807003681 NY Practitioner - Nurse Practitioner 6507155934 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician Sub II PLLCGroup PAC ID 1153584321, 12 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-7607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
30-306150NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician Sub II PLLC CurrentSince Sep 30, 2018 Accepting new patients
General Physician, PC CurrentSince Feb 1, 2018 Accepting new patients

Locations

100 High St
#362
Buffalo, NY 14203
Phone (716) 859-7607

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

875 Ellicott St
Buffalo, NY 14203
Phone (716) 748-2000

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

Interoperability endpoints

  • Direct secure messaging: khumphrey@gppc2.medentdirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1780939199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 WALTON DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142264832",
            "telephone_number": "716-310-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 WALTON DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142264832",
            "telephone_number": "716-310-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "A-NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "30-306150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.