Alexisa M Humphrey, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

225 Von Karman Rd
BLDG 225
Arnold AFB, TN 37389

Phone

(931) 454-5365

NPI assigned

Nov 25, 2013

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891125001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 MITCHELL ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373884156",
            "telephone_number": "702-427-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 VON KARMAN RD",
            "address_2": "BLDG 225",
            "city": "ARNOLD AFB",
            "state": "TN",
            "postal_code": "37389",
            "telephone_number": "931-454-5365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Nealy Ave",
            "address_purpose": "LOCATION",
            "city": "Langley AFB",
            "state": "VA",
            "postal_code": "236652040",
            "country_code": "US",
            "telephone_number": "757-225-2452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "ALEXISA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Suzanne Jackson, M.D.
• Robert Louchery, IDMT

• Independent Duty Medical Technicians in Arnold AFB, TN
• Providers in Arnold AFB, TN by specialty
• Independent Duty Medical Technicians in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.