Active NPI
Susan Humphries, RN
- Registered Nurse
- Monroe, LA
National Provider Identifier
1790812170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN080476
- Practice address
- 901 N 4TH St
Monroe, LA 71201-5909 - Phone
- (318) 387-7817
- Fax
- (318) 322-0914
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN080476 | LA | Primary |
Addresses
Primary practice location
901 N 4TH St
Monroe, LA 71201-5909
Mailing address
3014 N 12TH St
West Monroe, LA 71291-5021
Phone (318) 267-0840
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1591131 | Medicaid | LA |
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN080476 | LA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1790812170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3014 N 12TH ST",
"city": "WEST MONROE",
"state": "LA",
"postal_code": "712915021",
"telephone_number": "318-267-0840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 N 4TH ST",
"city": "MONROE",
"state": "LA",
"postal_code": "712015909",
"telephone_number": "318-387-7817",
"fax_number": "318-322-0914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMPHRIES",
"first_name": "SUSAN",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "LA",
"license": "RN080476",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1591131",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.