JESSICA NICOLE HUMPHREY (NPI# 1083865398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083865398 |
| Entity Type | Individual |
| Full Name | JESSICA NICOLE HUMPHREY |
| Credential | PA-C |
| Practice Address |
15540 Beech Daly Rd Midwest Urgent Care Redford Twp MI 48239 |
| Mailing Address |
31360 Northwestern Hwy Wendy Sadoff Md Dermatology PC Farmington Hills MI 48334 |
| Practice Telephone | 3135926330 |
| Mailing Telephone | 2488553300 |
| Mailing Fax Number | 2488553319 |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2014-11-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5601005400 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699396143 | Jessica Lynn Humphrey | Physician Assistant | 2566 Haymaker Rd, Monroeville, PA 15146-3517 | 2020-05-06 |
| 1346729563 | Jessica Humphrey | Physical Therapist | 1007 39th Ave Se, Puyallup, WA 98374-2192 | 2018-08-08 |
| 1912358359 | Jessica R Humphrey | Social Worker | 1911b Scottsville Rd, Bowling Green, KY 42104-3303 | 2016-06-27 |
| 1063845477 | Jessica Humphrey | Student in an Organized Health Care Education/Training Program | 187 W Schrock Rd, Westerville, OH 43081-2890 | 2013-08-21 |
| 1932448487 | Jessica Ann Humphrey | Counselor | 105 Loudon Rd, Concord, NH 03301-5601 | 2013-02-04 |
| Street Address |
15540 BEECH DALY RD MIDWEST URGENT CARE |
| City | REDFORD TWP |
| State | MI |
| Zip Code | 48239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942849856 | Court'nee Ann Desmond | Nurse Practitioner | 14761 Telegraph Rd, Redford, MI 48239 | 2019-12-26 |
| 1891250239 | Sun Valley Pharmacy LLC | Pharmacy | 9291 Telegraph Rd, Redford, MI 48239 | 2019-02-08 |
| 1003343369 | Lucinda Pryor | Nurse Practitioner | 14210 Marion, Redford, MI 48239 | 2017-05-17 |
| 1740725274 | Georgetta W Bond | Technician, Other | 12770 Hemingway, Redford, MI 48239 | 2016-12-19 |
| 1508318015 | Doris Mckinney | Counselor | Lincoln Behavioral Services - 9315 Telegraph, Redford, MI 48239 | 2016-10-31 |
| 1609282110 | Rosaundra Tanika Pope | Home Health | 9989 Royal Grand, Redford, MI 48239 | 2014-07-03 |
| 1497170179 | Courtney Ritchie | General Practice | 24435 Plymouth Rd, Redford, MI 48239 | 2014-03-04 |
| 1003168592 | Alicia Monique Lurry | Counselor | 8171 Parkland, Detroit, MI 48239 | 2012-10-08 |
| 1407116080 | Ariss Tiffani Pierce | Physical Therapist | 14615 Telegraph Rd Ste 1, Redford, MI 48239 | 2012-05-17 |
| 1205144409 | Steven Thomas Haynes | Counselor | 7411 Parkland, Redford, MI 48239 | 2010-09-22 |
| Find all providers in zip 48239 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841835303 | Gerard M Lefebvre Jr. | Physician Assistant | 5301 Mcauley Dr Ste 5112, Ypsilanti, MI 48197-1051 | 2019-11-08 |
| 1548611023 | Michael Scott Schaeffer II | Physician Assistant | 58070 Montego Dr, New Hudson, MI 48165-9735 | 2016-06-27 |
| 1700248176 | Katilyn Kohl | Physician Assistant | 3990 John R St Ste 4905, Detroit, MI 48201-2018 | 2016-03-24 |
| 1881052363 | Surgical Assist, Plc | Physician Assistant | 4409 Gaylord Dr, Troy, MI 48098-4458 | 2016-01-29 |
| 1710342134 | Evan Reid Vandenbosch | Physician Assistant | 36622 5 Mile Rd, Suite 101, Livonia, MI 48154-1900 | 2015-12-30 |
| 1619368008 | Matthew Eisen | Physician Assistant | 1560 E Sherman Blvd Ste 9, Muskegon, MI 49444-1867 | 2015-02-06 |
| 1609214972 | Jennifer Lynn Krishnan | Physician Assistant | 3601 E 13 Mile Rd, Royal Oak, MI 48073-6769 | 2013-06-10 |
| 1093028441 | Lonna Petronella Van Ast | Physician Assistant | 1022 Ada Place Dr Se, Grand Rapids, MI 49546-3786 | 2010-07-14 |
| 1669707170 | Luke Thomas Dillon | Physician Assistant | 3100 Cross Creek Pkwy Ste 200, Auburn Hills, MI 48326-2776 | 2009-10-16 |
| 1912139544 | Richard Lawrence Burgett Sr. | Physician Assistant | 4327 Stone Ridge Dr, Traverse City, MI 49684-7958 | 2009-08-15 |
| Find all providers with the same taxonomy | ||||
| City | REDFORD TWP |
| Zip Code | 48239 |
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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.