SIDNEY ALAN HUMPHREY PA-C NPI 1659349405

NPI Information

NPI: 1659349405
Provider Name: SIDNEY ALAN HUMPHREY, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
5430 MACCORKLE AVE SE
CHARLESTON, WV
ZIP 25304
Phone: (304) 925-3627
Get Directions

Sidney Alan Humphrey, PA-C is a medical physician assistant in Charleston, WV. Sidney Alan Humphrey, PA-C NPI is 1659349405. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5430 MACCORKLE AVE SE
CHARLESTON, WV
ZIP 25304-224
Phone: (304) 925-3627
Fax: (304) 925-1163

The NPI 1659349405 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/9/2006 and was last updated on 6/2/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		306	WEST VIRGINIA	No
2	363AM0700X	Physician Assistant	Medical	811	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P66523	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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