Individual provider Active NPI

Jay Thomas Humphrey, D.C.

  • Chiropractor
  • Rockwall, TX
National Provider Identifier
1972787992
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
10730 Issued in TX
Practice address
1160 Horizon Rd
Rockwall, TX 75032-5498
Phone
(972) 722-8800
Fax
(972) 722-8804
NPI assigned
Dec 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10730 TX Primary

Addresses

Primary practice location

1160 Horizon Rd
Rockwall, TX 75032-5498

Mailing address

433 E Interstate 30
Rockwall, TX 75087-5406
Phone (972) 722-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090423000265 TX Practitioner - Chiropractic 4880742212

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

433 E Interstate 30
Rockwall Spine and Sports Medicine
Rockwall, TX 75087-5406
Phone (972) 722-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10730TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jay Humphrey DC PA CurrentSince Feb 6, 2011 Accepting new patients
Collaborative Health Group, PLLC PastSince Feb 6, 2011 Accepting new patients
Mary L Collings, PA Chiropractor PastSince Apr 15, 2009 Accepting new patients

Locations

1160 Horizon Rd
Rockwall, TX 75032
Phone (972) 498-1100

433 E Interstate 30
Rockwall, TX 75087
Phone (972) 722-8800

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1972787992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 E INTERSTATE 30",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750875406",
            "telephone_number": "972-722-8800",
            "fax_number": "972-722-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 HORIZON RD",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750325498",
            "telephone_number": "972-722-8800",
            "fax_number": "972-722-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "JAY",
        "middle_name": "THOMAS",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-27",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.