Individual provider Active NPI

Brittany Nicole Humble, FNP-BC

  • Family Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1831676550
Registry record updated Sep 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP138250 Issued in TX
Practice address
2693 North St
Beaumont, TX 77702
Phone
(409) 832-8862
NPI assigned
Jul 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP138250 TX Primary

Addresses

Primary practice location

2693 North St
Beaumont, TX 77702

Mailing address

15325 FM 421 Rd
Kountze, TX 77625-6325
Phone (409) 790-0394

Other names 1

  • Brittany Nicole Odom Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20181108000411 TX Practitioner - Nurse Practitioner 9032463146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Texas Cardiology Associates II LLPGroup PAC ID 8426152372, 7 clinicians

Practice addresses (Care Compare)

2693 N St
Beaumont, TX 77702-1624
Phone (409) 832-8862

Hospital & facility affiliations

  • Baptist Beaumont Hospital Hospital, Beaumont, TX, CCN 450346
  • Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP138250TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Texas Cardiology Associates II LLP CurrentSince Oct 1, 2018 Accepting new patients
Cardiac Imaging Inc PastSince Oct 1, 2018 Accepting new patients

Locations

2693 North St
Beaumont, TX 77702
Phone (409) 832-8862

2670 McFaddin St
Beaumont, TX 77702
Phone (409) 832-8862

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5553/brand/1/csg/1/fhir/r4
  • Direct secure messaging: brittany.odom.1@5553.direct.athenahealth.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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537574400000",
    "number": "1831676550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15325 FM 421 RD",
            "city": "KOUNTZE",
            "state": "TX",
            "postal_code": "776256325",
            "telephone_number": "409-790-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2693 NORTH ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77702",
            "telephone_number": "409-832-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMBLE",
        "first_name": "BRITTANY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2018-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "ODOM",
            "middle_name": "NICOLE",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.