MRS. KALLIE BLYTHE HUMPHREYS (NPI# 1194061143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194061143 |
| Entity Type | Individual |
| Full Name | MRS. KALLIE BLYTHE HUMPHREYS |
| Credential | PA-C |
| Practice Address |
3300 Nw Expressway Oklahoma City OK 73112-4999 |
| Mailing Address |
Po Box 269032 Oklahoma City OK 73126-9032 |
| Practice Telephone | 4059493011 |
| Mailing Telephone | 4059512545 |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2020-06-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
APA2188 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2825 Parklawn Dr, Midwest City, OK 731104201 | 4056104411 |
| Street Address |
3300 NW EXPRESSWAY |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73112-4999 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578567848 | Gregory W Dinwiddie | Physician Assistant | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2005-06-02 |
| 1760083554 | Cristin Michelle Fong | Nurse Practitioner | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-11-06 |
| 1578160487 | Jennifer Bauman | Nurse Practitioner | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-10-04 |
| 1013525062 | Siera Alexis Freeman | Physical Therapist | 3300 Nw Expressway, Oklahoma City, OK 73112 | 2020-07-15 |
| 1447878152 | Sabrina Smith | Registered Nurse | 3300 Nw Expressway, Oklahoma City, OK 73112-4999 | 2020-07-09 |
| 1881219756 | Paul Rakowski | Emergency Medicine | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-06-16 |
| 1902429707 | Alex D Dumontier | Anesthesiologist Assistant | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-05-27 |
| 1417577305 | Oklahoma Emergency Physicians LLC | Emergency Medicine | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-04-21 |
| 1871113761 | Oklahoma Hospital Medicine Physicians LLC | Internal Medicine | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-04-21 |
| 1043839459 | Taylor Egbert | Student in an Organized Health Care Education/Training Program | 3300 Nw Expressway, Oklahoma City, OK 73112-4999 | 2020-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145886 | Crystopher J Long | Physical Therapist | Parkway Post Acute Recovery Center, 6312 N Portland, Oklahoma City, OK 73112 | 2019-10-11 |
| 1700448974 | Joy Healthcare Services of Okc LLC | Home Health | 4200 Perimeter Center Drive, Suite 125, Oklahoma City, OK 73112 | 2019-07-08 |
| 1801380159 | Crysten Cheatwood Do, PC | Obstetrics & Gynecology | 3433 Nw 56 Street, Suite 210b, Oklahoma City, OK 73112 | 2018-06-20 |
| 1306352521 | Victoria Ann Kappel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3466 Nw 56th St. Suite 760, Oklahoma City, OK 73112 | 2017-12-26 |
| 1871014886 | Tanesia Michelle Smith | Case Management | 2629 W I44 Service Rd, Suite 202, Oklahoma City, OK 73112 | 2017-06-29 |
| 1619414257 | Edwige Gwanyama | Student in an Organized Health Care Education/Training Program | 2401 Nw 39 Th Expy Ste 103, Oklahoma City, OK 73112 | 2017-01-20 |
| 1619424017 | Jennifer Beaver | Peer Specialist | 2808 Nw 31st, Oklahoma City, OK 73112 | 2016-09-02 |
| 1417305368 | Gabriel Plank | Counselor | 3000 Founders Blvd Suite239, Oklahoma City, OK 73112 | 2016-06-01 |
| 1912364365 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 4101 N May Ave, Oklahoma City, OK 73112 | 2016-01-15 |
| 1679938922 | Portland Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | 5501 N Porland Ave, Oklahoma City, OK 73112 | 2015-12-30 |
| Find all providers in zip 73112 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982172029 | William Landon Ross | Physician Assistant | 3705 W Memorial Rd Ste 101, Oklahoma City, OK 73134-1508 | 2018-11-07 |
| 1639646656 | Jacob Allbritton | Physician Assistant | 10824 Admiral Dr, Oklahoma City, OK 73162-6843 | 2018-10-29 |
| 1073004768 | Shelby Teel | Physician Assistant | 1200 Everett Dr # 8305, Oklahoma City, OK 73104-5047 | 2018-05-29 |
| 1255871349 | Michele Starr | Physician Assistant | 409 Nw 39th St, Oklahoma City, OK 73118-8415 | 2017-03-08 |
| 1972042141 | Nathan Carl Kadavy | Physician Assistant | 440 N Portland Ave, Suite 1000, Oklahoma City, OK 73107-6110 | 2017-02-21 |
| 1487191946 | Neilee Wood | Physician Assistant | 8121 Nw 119th St, Oklahoma City, OK 73162-1110 | 2017-01-23 |
| 1508316530 | Shayniel Stears | Physician Assistant | 16201 Gossamer Way, Oklahoma City, OK 73165-1503 | 2016-10-13 |
| 1386016566 | D'amber Nicole Chambers | Physician Assistant | 1918 Ne 23rd St, Oklahoma City, OK 73111-3328 | 2015-10-27 |
| 1700263928 | Micaela Lupov | Physician Assistant | 101 N Robinson Ave Ste 200, Oklahoma City, OK 73102 | 2015-04-27 |
| 1710380001 | Whitney Ward | Physician Assistant | 4120 W Memorial Rd Ste 300, Oklahoma City, OK 73120-9322 | 2014-10-01 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73112 |
Please comment or provide details below to improve the information on MRS. KALLIE BLYTHE HUMPHREYS.
| 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.