DR. DIEGO SEBASTIAN HUMPHREY (NPI# 1073525515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073525515 |
| Entity Type | Individual |
| Full Name | DR. DIEGO SEBASTIAN HUMPHREY |
| Credential | MD |
| Practice Address |
1500 E. Downing # Tahlequah OK 74464 |
| Mailing Address |
Po Box 1008 Tahlequah OK 74465-1008 |
| Practice Telephone | 9182070882 |
| Practice Fax Number | 9182070335 |
| Mailing Telephone | 9182070882 |
| Mailing Fax Number | 9182070335 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2020-04-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
19979 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100037340A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 Rockefeller Dr, Muskogee, OK 744015075 | 9186825501 | 9186842552 |
| Street Address |
1500 E. DOWNING # |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730790148 | Epic Heart Health | Internal Medicine | 1211 N Shartel Ave Ste 1005, Oklahoma City, OK 73103-2433 | 2020-08-11 |
| 1801355813 | Tulsa Cardiovascular Center of Excellence, L.l.c | Internal Medicine | 11912 S Norwood Ave Ste 105, Tulsa, OK 74137-5509 | 2019-03-19 |
| 1316469109 | Razan Ali Mohamed Elsayed | Internal Medicine | 800 Stanton L Young Blvd # 5481, Oklahoma City, OK 73104-5018 | 2017-07-12 |
| 1184043556 | Heart & Vascular Specialist of Oklahoma Pllc | Internal Medicine | 15601 Kestral Park Ct, Edmond, OK 73013-9505 | 2014-04-14 |
| 1316283724 | Jean Ann Pitts | Internal Medicine | 11177 Ns 367 Rd, Okemah, OK 74859-4437 | 2012-12-13 |
| 1356621353 | Taraka Vijaya Rama Raju Gadiraju | Internal Medicine | 6151 S Yale Ave Ste 1-304, Tulsa, OK 74136-1907 | 2011-08-22 |
| 1760776694 | Biyebelemo A Ekpete | Internal Medicine | 2115 Duncan Regional Loop Ste 200, Duncan, OK 73533-1577 | 2011-06-08 |
| 1174750749 | Matthew Joseph Comstock | Internal Medicine | 11912 S Norwood Ave Ste 110, Tulsa, OK 74137-5509 | 2009-06-22 |
| 1841441151 | Mohamad A. Mahayni, M.d., Inc. | Internal Medicine | 3502 W Okmulgee St, Muskogee, OK 74401-5073 | 2008-10-06 |
| 1225201718 | Christian Cardiovascular Institute PC | Internal Medicine | 3300 Nw 56th Street, Suite 200, Oklahoma City, OK 73112-4401 | 2008-04-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.