Crystal Jane Humphries, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3011675 Issued in KY

Practice address

1718 Alexandria Dr
Lexington, KY 40504-3144

Phone

(859) 276-1015

Fax

(859) 277-1015

NPI assigned

Aug 25, 2017

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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Resurrection Treatment Clinics LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Lexington, KY
  • NPI 1548633415
  Medicare reassignment NPD

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1962929307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 CREEK ROCK CIR",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403568037",
            "telephone_number": "859-948-3697",
            "fax_number": "502-863-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 ALEXANDRIA DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043144",
            "telephone_number": "859-276-1015",
            "fax_number": "859-277-1015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1092 DuVal St Ste 230",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405158908",
            "country_code": "US",
            "telephone_number": "859-523-7383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMPHRIES",
        "first_name": "CRYSTAL",
        "middle_name": "JANE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3011675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BETTER HEALTH",
            "identifier": "PDZ000000064864",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300009625",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "9919431",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100519400",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000001143675",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE ID",
            "identifier": "CS1814200203",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mathew Jacob Scott Hummel, CRNA
• Corey Humphrey, PHARMD
• Samantha Humphrey, MSW
• Stephen Howard Humphrey, PHARM. D.
• Natalie G Humphreys, CRNA
• Jeri Humphries, PA
• Kimberly S Humphries, PA-C
• Kristina D. Humphries, MD
• Laurie Lee Humphries, MD
• Roger L Humphries, MD

• Family Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.