Active NPI
Dean Robert Humphreys, NP
- Family Nurse Practitioner
- Syracuse, NY
National Provider Identifier
1902833072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F331902
- Practice address
- VA Medical Center, 800 Irving Avenue
Cardiology
Syracuse, NY 13210 - Phone
- (315) 425-2935
- Fax
- (315) 425-2937
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F331902 | NY | Primary |
Addresses
Primary practice location
VA Medical Center, 800 Irving Avenue
Cardiology
Syracuse, NY 13210
Mailing address
8424 Esperance TRL
Liverpool, NY 13090-4108
Phone (315) 652-9686
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)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F331902 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902833072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8424 ESPERANCE TRL",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130904108",
"telephone_number": "315-652-9686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VA MEDICAL CENTER, 800 IRVING AVENUE",
"address_2": "CARDIOLOGY",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "13210",
"telephone_number": "315-425-2935",
"fax_number": "315-425-2937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMPHREYS",
"first_name": "DEAN",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F331902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.