CRYSTAL JANE HUMPHRIES (NPI# 1962929307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962929307 |
| Entity Type | Individual |
| Full Name | CRYSTAL JANE HUMPHRIES |
| Credential | APRN |
| Practice Address |
101 Prosperous Pl Ste 300 Lexington KY 40509-1836 |
| Mailing Address |
101 Cabarrus Ave E Ste 200 Concord NC 28025-3781 |
| Practice Telephone | 8592755229 |
| Practice Fax Number | 8599772683 |
| Mailing Telephone | 8888497379 |
| Mailing Fax Number | 8558577333 |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2019-06-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3011675 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ANTHEM PIN | 000001143675 | 01 | |
| KY | 7100519400 | 05 | |
| AETNA BETTER HEALTH | PDZ000000064864 | 01 | |
| IN | 300009625 | 05 | |
| AETNA PIN | 9919431 | 01 | |
| CARESOURCE ID | CS1814200203 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 Cabarrus Ave E Ste 200, Concord, NC 280253781 | 8888497379 | 8558577333 |
| 2232 Sunningdale Dr, Lexington, KY 405098512 | 8599483697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700882131 | Crystal E Humphries | Nurse Practitioner | 101 E Wood St, Spartanburg, SC 29303-3040 | 2005-06-21 |
| Street Address |
101 PROSPEROUS PL STE 300 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40509-1836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427003524 | David Wendell Moore | Physician Assistant | 101 Prosperous Pl Ste 300, Lexington, KY 40509-1836 | 2006-05-24 |
| 1780190348 | Commonwealth Pain Associates, Pllc | Durable Medical Equipment & Medical Supplies | 101 Prosperous Pl Ste 300, Lexington, KY 40509-1836 | 2017-12-19 |
| 1558629410 | Brandon Erik Gish | Anesthesiology | 101 Prosperous Pl Ste 300, Lexington, KY 40509-1836 | 2012-04-30 |
| 1780845347 | Anjum Bux, M.d., P.s.c. | Registered Nurse | 101 Prosperous Pl Ste 300, Lexington, KY 40509-1836 | 2008-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453640 | Grace T. Hallak | Counselor | 513 Darby Creek Rd, Lexington, KY 40509 | 2019-08-19 |
| 1932755774 | Lexington-fayette Urban-county Health Department | Public Health or Welfare | 4801 Athens Boonesboro Rd, Lexington, KY 40509 | 2019-08-16 |
| 1497308266 | Discover You Counseling LLC | Social Worker | 513 Darby Creek Drive, Unit 56 D, Lexington, KY 40509 | 2019-07-22 |
| 1407323611 | Trevor Douglas Mchardy | Physician Assistant | 101 North Eagle Creek Drive, Lexington, KY 40509 | 2018-10-25 |
| 1114413184 | Megan Medrano | Dietitian, Registered | 163 Old Todds Rd Ste 115, Lexington, KY 40509 | 2018-07-02 |
| 1750884292 | Active Medical LLC | Durable Medical Equipment & Medical Supplies | 3470 Blazer Pkwy Ste 350, Lexington, KY 40509 | 2018-03-12 |
| 1699273599 | Frederick Douglas High School | Public Health or Welfare | 2000 Winchester Rd, Lexington, KY 40509 | 2018-01-25 |
| 1710409370 | Sleep Identity Pllc | Clinic/Center | 541 Darby Creek Road, Ste 190, Lexington, KY 40509 | 2017-07-14 |
| 1164956397 | Danielle Anderson | Family Medicine | 24 Fountain Court, Suite 225, Lexington, KY 40509 | 2017-04-14 |
| 1356891782 | Dawn Jones | Physician Assistant | 101 N Eagle Creek Dr, Ste 120, Lexington, KY 40509 | 2016-10-10 |
| Find all providers in zip 40509 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225161 | Christina Chan Sok | Nurse Practitioner | 24 Hartwell Ave # 204, Lexington, MA 02421-3132 | 2020-11-05 |
| 1871194381 | Stacie Rose | Nurse Practitioner | 131 Hartwell Ave, Lexington, MA 02421-3105 | 2020-11-03 |
| 1952900870 | Sarah Elizabeth Clark | Nurse Practitioner | 1309 Morning Side Ct, Lexington, KY 40509-2353 | 2020-10-21 |
| 1629677745 | Lisa Elaine Coleman | Nurse Practitioner | 2241 Gulfstream Dr, Lexington, KY 40504-3273 | 2020-10-20 |
| 1578161303 | Mariem Kader | Nurse Practitioner | 3622 White Pine Dr, Lexington, KY 40514-1740 | 2020-10-14 |
| 1023616125 | Kimberly Dawn Calloway | Nurse Practitioner | 5306 E Blocher Rd, Lexington, IN 47138-8803 | 2020-10-12 |
| 1649878992 | Margaret Bunch | Nurse Practitioner | 171 W Lowry Ln Ste 132, Lexington, KY 40503-3006 | 2020-10-09 |
| 1831701572 | Jillian Leigh Butcher | Nurse Practitioner | 2917 Mahala Ln, Lexington, KY 40509-8555 | 2020-08-22 |
| 1033721154 | Heart Rescue Cpr LLC | Nurse Practitioner | 501 Darby Creek Rd Ste 18, Lexington, KY 40509-1606 | 2020-08-19 |
| 1619588241 | Jordyn L Bush | Nurse Practitioner | 124 Clay Ave, Lexington, KY 40502-1702 | 2020-08-17 |
| Find all providers in LEXINGTON | ||||
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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.