NPIMap

Individual provider Active NPI

Callie Anne Humphreys, DNAP

  • Certified Registered Nurse Anesthetist
  • Charleston, WV
National Provider Identifier
1831834290
Registry record updated Oct 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
120955 Issued in WV
Practice address
3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Phone
(304) 388-4077
Fax
(304) 388-9852
NPI assigned
Apr 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 92490 WV
Certified Registered Nurse Anesthetist 367500000X 120955 WV Primary

Addresses

Primary practice location

3200 Maccorkle Ave SE
Charleston, WV 25304-1227

Mailing address

100 Angus E Peyton Dr
South Charleston, WV 25303-1600
Phone (304) 746-2088

Other names 1

  • Callie Anne Tierney Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260122001823 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961989876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
92490WVMDRegistered Nurse
120955WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Oct 12, 2025 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Oct 12, 2025 Accepting new patients

Locations

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

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 11

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": "1651276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1831834290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ANGUS E PEYTON DR",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253031600",
            "telephone_number": "304-746-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-4077",
            "fax_number": "304-388-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "CALLIE",
        "middle_name": "ANNE",
        "credential": "DNAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-30",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "92490",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "120955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALLIE",
            "last_name": "TIERNEY",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.