Kellie Humphrey, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22357 Issued in TN

Practice address

5221 Ravens GLN
Nashville, TN 37211-8596

Phone

(931) 743-3559

Fax

(615) 577-3324

NPI assigned

Mar 2, 2017

Last updated

Nov 23, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coffee County Hospital Group IncGroup PAC ID 1456317783, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aveanna Home Health Home health agency, Murfreesboro, TN, CCN 447163
• Adoration Home Health, LLC Home health agency, Madison, TN, CCN 447581
• Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coffee Medical Group LLC

  dba Unity Medical Center

  • Rural Acute Care Hospital
  • Manchester, TN
  • NPI 1013969179
  Medicare reassignment NPD
• Housecall Today, Inc

  • Family Medicine Physician
  • Nashville, TN
  • NPI 1326217852
  Medicare reassignment NPD
• Coffee Medical Group LLC

  dba Center for Family Medicine

  • Rural Health Clinic/Center
  • Manchester, TN
  • NPI 1700192028
  Care Compare group
• Coffee Medical Group LLC

  dba Manchester Rural Health Clinic

  • Rural Health Clinic/Center
  • Manchester, TN
  • NPI 1043537046
  NPD
• Infinity Resources Inc

  • Family Nurse Practitioner
  • Nashville, TN
  • NPI 1629204037
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adoration Home Health, LLC

  dba Adoration Home Health

  • Home Health Agency
  • Madison, TN
  • NPI 1790161321
  Care Compare affiliation
• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  Care Compare affiliation
• Willowbrook Home Health Care Agency, Inc.

  dba Aveanna Home Health

  • Home Health Agency
  • Murfreesboro, TN
  • NPI 1356348684
  Care Compare affiliation

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574467200000",
    "number": "1992245401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1493 ANTHONY WAY",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223558",
            "telephone_number": "931-743-3559",
            "fax_number": "615-577-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5221 RAVENS GLN",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372118596",
            "telephone_number": "931-743-3559",
            "fax_number": "615-577-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "KELLIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2019-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ammie Diane Humphrey, CNM
• Andrea Claire Humphrey, RBT
• Carly Humphrey
• Hollie Humphrey
• Joshua Humphrey, ACNP
• Kevin Guy Humphrey, MS, RD, LDN
• Kiara A Humphrey
• Lisa Michelle Humphrey, CRNA
• Pamela Humphrey, APRN,FNP-BC
• Steven S Humphrey, MD

• Family Nurse Practitioner in Nashville, TN
• Providers in Nashville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2019; 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.
• 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.