Michael Roy Humphrey II, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 26311 Issued in FL

Practice address

1438 SW Main Blvd
Lake City, FL 32025-1106

Phone

(386) 755-3164

NPI assigned

Jan 3, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pro Motion Therapy of Lake City LLC

  • Physical Therapy Clinic/Center
  • Gainesville, FL
  • NPI 1538358585
  NPD (past)

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

{
    "created_epoch": "1451779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451779200000",
    "number": "1821454117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 SW LEGION DR",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320244072",
            "telephone_number": "850-661-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251106",
            "telephone_number": "386-755-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "MICHAEL",
        "middle_name": "ROY",
        "name_suffix": "II",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-03",
        "last_updated": "2016-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 26311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miranda Howes
• Gerald Robert Hoyt, LMHC
• Eddie James Hukle, RPH, PHARMD
• Hull Health Transportation LLC
• Angel Martin Hull
• Brandy W Hunt, RDH
• Kelli Lynn Hunt, M.ED., CCC-SLP
• Kimberly A Hunt, LMHC
• Kimberly Hunter
• Markie Hunter

• Physical Therapy Assistant in Lake City, FL
• Providers in Lake City, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.