Charles Brady Humphrey, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02592 Issued in TX

Practice address

1002 Texas Blvd Ste 400
Texarkana, TX 75501-5113

Phone

(903) 838-5500

Fax

(903) 838-7402

NPI assigned

Nov 13, 2007

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 identifiers 2

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

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

James M Hurley MD PAGroup PAC ID 8527002633, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

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.

• James M Hurley MD PA

  dba Texarkana Cardiology Associates

  • Cardiovascular Disease Physician
  • Texarkana, TX
  • NPI 1215974076
  Medicare reassignment Care Compare group
• C H Wilkinson Physician Network

  dba CHRISTUS Physician Group

  • Family Medicine Physician
  • Irving, TX
  • NPI 1457382947

  Physician Assistant

  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment NPD
• C H Wilkinson Physician Network

  dba CHRISTUS Physician Group

  • Orthopaedic Surgery Physician
  • Corpus Christi, TX
  • NPI 1750826095
  NPD
• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD

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

• Christus Health Ark-la-Tex

  dba Christus St. Michael Health System

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  dba CHRISTUS St. Michael Health System

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1881874394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 TEXAS BLVD STE 400",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015113",
            "telephone_number": "903-838-5500",
            "fax_number": "903-838-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 TEXAS BLVD STE 400",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015113",
            "telephone_number": "903-838-5500",
            "fax_number": "903-838-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "CHARLES",
        "middle_name": "BRADY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-13",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297050101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200515720A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Breezye Huddleston
• Felicia Phay Huddleston, FNP
• John E Hueter, MD
• Jessica Leigh Huett, CRNA
• Tiffany A Hughes, APRN, AGNP-C
• Stacy Michelle Humphrey, LPC
• Cheryl Ann Hunter
• George R Hunter, MD
• David Hurlburt, LPC
• James Michael Hurley, M.D.

• Physician Assistant in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.