Carl Scott Humphrey, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

M9563 Issued in ID

Practice address

3381 W Bavaria Street
Eagle, ID 83616-5341

Phone

(208) 639-4800

Fax

(208) 639-4801

NPI assigned

Nov 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. C Scott Humphrey Professional name

Medicare fee-for-service enrollment

Enrolled in ID

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

Orthopedic Surgery

Education

University of Utah School of Medicine, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Boise Shoulder Clinic, PAGroup PAC ID 4688671621, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boise Shoulder Clinic, PA

  dba Humphrey Shoulder Clinic

  • Orthopaedic Surgery Physician
  • Eagle, ID
  • NPI 1760581409
  Medicare reassignment Care Compare group Authorized official

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

• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1811978778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3381 W BAVARIA STREET",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165341",
            "telephone_number": "208-639-4800",
            "fax_number": "208-639-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3381 W BAVARIA STREET",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165341",
            "telephone_number": "208-639-4800",
            "fax_number": "208-639-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "CARL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M9563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C",
            "last_name": "HUMPHREY",
            "middle_name": "SCOTT",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Huckleberry Home Health, LLC
• Huckleberry Hospice, LLC
• Heidi Alisha Huffman, LPC
• Coleen D Hulbert, MD
• David R. Hulbert, M.D.
• Carrie Ann Humphrey, MD
• James J Hunt, PHARMD
• Mary Ann Z. Huntington, MD
• Idaho Allergy L.L.C.
• Idaho Center for Regenerative Medicine

• Orthopaedic Surgery Physician in Eagle, ID
• Providers in Eagle, ID by specialty
• Orthopaedic Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; 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.