RUSSELL SHANNON HUMPHRIES (DC) – Chiropractor, NPI 1497769210

RUSSELL SHANNON HUMPHRIES (DC) is a healthcare provider. based in Port orange, Florida. specializing in CHIROPRACTIC. They hold the professional credentials DC. They hold a License No. CH3773 (FL). The NPI Number for RUSSELL SHANNON HUMPHRIES (DC) is 1497769210

Main info

Male
45 Years Of Experience
Accepts Medicare Assignment
Name
RUSSELL SHANNON HUMPHRIES (DC)
NPI
1497769210
Phone
(386) 767-2727
Address
4343 RIDGEWOOD AVENUE
Enumeration Date
28 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
LIFE CHIROPRACTIC COLLEGE
Secondary Phone
-
Graduation Year
1981 (45 years ago)
PAC ID
1759558505
Professional Enrollment ID
I20120118000673
Address ID
FL321274542PO4343XBXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,472 CHIROPRACTIC in FL

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Provider Addresses for RUSSELL SHANNON HUMPHRIES (DC)

  • 4343, South Ridgewood Avenue, Port Orange, Volusia County, Florida, 32127, United States

    SUITE B

    PORT ORANGE, FL 32127

    Phone: (386) 767-2727

    Fax: (386) 767-6674

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-01-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120118000673IChiropracticFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98942Chiropractic manipulative treatment, 5 spinal regions1,30665$0
View full utilization report →

Insurance plans in this area (ZIP 32127)

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Reviews

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Frequently asked questions

How do I look up RUSSELL SHANNON HUMPHRIES (DC) by NPI?
Use NPI 1497769210 when you need to reference RUSSELL SHANNON HUMPHRIES (DC) in forms, claims, or directories.
Does this profile mean RUSSELL SHANNON HUMPHRIES (DC) is currently active?
Yes — RUSSELL SHANNON HUMPHRIES (DC) appears active in the national provider directory.
Can you summarize RUSSELL SHANNON HUMPHRIES (DC)'s specialty in plain language?
Clinically, the directory lists RUSSELL SHANNON HUMPHRIES (DC) with Chiropractor. Clinical services aligned with this taxonomy classification.
Does RUSSELL SHANNON HUMPHRIES (DC) practice in Florida?
You will see Port Orange, Florida on file for RUSSELL SHANNON HUMPHRIES (DC) alongside any extra practice locations.
Is RUSSELL SHANNON HUMPHRIES (DC) a real provider?
This page reflects official NPPES data for NPI 1497769210. Always confirm identity and privileges with the practice and licensing boards.

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