Jordan Humphreys
Individual provider Active NPI Pharmacist · Decatur, TN
NPI 1962332072 · NPPES record last updated May 20, 2026
Key facts
- NPI
- 1962332072
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 43791 (TN)
- Practice address
- 392 N Main St
Decatur, TN 37322-7759 - Phone
- (423) 565-0200
- NPI assigned
- May 20, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 43791 | TN | Yes |
Addresses
Primary practice location
392 N Main St
Decatur, TN 37322-7759
Mailing address
392 N Main St
Decatur, TN 37322-7759
Other providers in Decatur, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.