Individual provider Active NPI

Andria J Humphrey-Johnson, M.D.

  • Family Medicine Physician
  • Nashville, TN
National Provider Identifier
1902070238
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47797 Issued in TN
Practice address
7640 Highway 70 S
Suite 110
Nashville, TN 37221
Phone
(629) 255-2053
Fax
(629) 255-4128
NPI assigned
Apr 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 47797 TN Primary

Addresses

Primary practice location

7640 Highway 70 S
Suite 110
Nashville, TN 37221

Mailing address

222 22ND Ave N
Nashville, TN 37203-1852
Phone (629) 255-3486

Other identifiers 1

IdentifierTypeStateIssuer
1525690MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47797TNMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1902070238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 22ND AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031852",
            "telephone_number": "629-255-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7640 HIGHWAY 70 S",
            "address_2": "SUITE 110",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37221",
            "telephone_number": "629-255-2053",
            "fax_number": "629-255-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY-JOHNSON",
        "first_name": "ANDRIA",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "47797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525690",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

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