STEPHEN M. HUMPHREY (NPI# 1154379428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154379428 |
| Entity Type | Individual |
| Full Name | STEPHEN M. HUMPHREY |
| Credential | MD |
| Practice Address |
10614 N Port Washington Rd Mequon WI 53092-5013 |
| Mailing Address |
2001 Butterfield Rd Suite 300 Downers Grove IL 60515-1050 |
| Practice Telephone | 2628340123 |
| Mailing Telephone | 6307252700 |
| Mailing Fax Number | 8774895993 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2019-12-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
036106450 | IL | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
036106450 | IL | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
44460 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34237200 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 245 S Executive Dr Ste 350, Brookfield, WI 530054214 | 2623731647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184776163 | Stephen Michael Humphrey | Psychologist | 602 New Britain Ave, Hartford, CT 06106-4033 | 2007-01-18 |
| 1235138819 | Stephen Harmes Humphrey | Internal Medicine | 1655 Bernardin Ave, Suite 220, Columbia, SC 29204-2039 | 2005-07-18 |
| 1710984570 | Stephen S Humphrey | Urology | 2145 N Fairfield Rd, Ste B, Beavercreek, OH 45431-2580 | 2005-07-07 |
| 1154605640 | Stephen Howard Humphrey | Pharmacist | 2209 Richmond Rd, Lexington, KY 40502-1306 | 2011-10-04 |
| 1417246257 | Stephen Raymond Humphrey | Dermatology | 9000 W Wisconsin Ave, Pediatric Dermatology, Milwaukee, WI 53226-4874 | 2011-04-01 |
| 1689647539 | Stephen R Humphrey | Dentist | 10001 N Washington St, Thornton, CO 80229-2050 | 2006-02-10 |
| Street Address |
10614 N PORT WASHINGTON RD |
| City | MEQUON |
| State | WI |
| Zip Code | 53092-5013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295780492 | Wisconsin Phlebology Medical Group Sc | Phlebology | 10614 N Port Washington Rd, Mequon, WI 53092-5013 | 2006-05-24 |
| 1245282086 | Mark W Francis | Emergency Medicine | 10614 N Port Washington Rd, Mequon, WI 53092-5013 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942790761 | Kathryn Mueller | Specialist/Technologist | 117 Linden Lane, Apt 7, Thiensville, WI 53092 | 2018-05-17 |
| 1427547082 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 10996 N Port Washington Rd, Mequon, WI 53092 | 2018-05-08 |
| 1912437252 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | 11430 Port Washington Road, Mequon, WI 53092 | 2017-06-19 |
| 1629437256 | Sean S Tsang | Acupuncturist | 909 W. Mequon Rd., Mequon, WI 53092 | 2016-02-10 |
| 1497128433 | Nancy Snoots | Counselor | 4430 W Tarrytown Ln, Mequon, WI 53092 | 2015-11-12 |
| 1609265214 | Evan Guettel | Physical Therapist | 11363 N. Port Washington Road, Mequon, WI 53092 | 2015-01-20 |
| 1881091148 | Sarah Krueger | Counselor | 216 N Green Bay Rd Suite 108, Thiensville, WI 53092 | 2014-12-01 |
| 1245667088 | Lora Transportation, LLC | Non-emergency Medical Transport (VAN) | 1228 West Baldwin Crt., Mequon, WI 53092 | 2013-10-10 |
| 1710314000 | Roxxi M Davis | Social Worker | 7113 Tamarack Ct, Mequon, WI 53092 | 2013-10-01 |
| 1225473713 | Forefront Dermatology, S.c. | Dermatology | 10303 N Port Washington Rd Ste 101, Mequon, WI 53092 | 2013-05-09 |
| Find all providers in zip 53092 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013999564 | John Tomashek | Radiology | 10945 N Port Washington Rd Ste 201, Mequon, WI 53092-5078 | 2005-11-18 |
| 1265414809 | James Beres | Radiology | 10945 N Port Washington Rd Ste 201, Mequon, WI 53092-5078 | 2005-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245520840 | Sujan Swearingen | Radiology | 5931 Pilgrim Way, Racine, WI 53406-2739 | 2011-04-15 |
| 1124289657 | Farzad Rezai | Radiology | 624 N 59th St, Milwaukee, WI 53213-4214 | 2008-06-18 |
| 1679507883 | Center for Medical Imaging Inc | Radiology | W178n9912 Rivercrest Dr, Suite 102, Germantown, WI 53022-4645 | 2006-07-11 |
| 1003869140 | Interventional Procedures Group Ltd | Radiology | 2445 North Mayfair Road, Wauwatosa, WI 53226 | 2006-05-18 |
| 1063473692 | William G Wagner | Radiology | 1601 N Taylor Dr, Sheboygan, WI 53081-1930 | 2006-03-31 |
| 1902260433 | Jiahao Hu | Radiology | 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | 2016-04-11 |
| 1720443922 | Elliott Russell | Radiology | Uw Hospitals & Clinics 600 Highland Ave, Madison, WI 53792-0001 | 2015-12-15 |
| 1104212091 | Osmani Deochand | Radiology | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2015-04-08 |
| 1447666219 | Chadi Diab | Radiology | 600 Highland Ave, Madison, WI 53792-2709 | 2014-07-01 |
| 1255743860 | Naif Hamad Alsaikhan | Radiology | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2014-05-30 |
| 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.