JACOB A HUMPHREY (MD) – Pediatric Nephrology Physician, NPI 1003340472
Pediatric Nephrology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
431 NEPHROLOGY in GA
Provider Addresses for JACOB A HUMPHREY (MD)
2174 N DRUID HILLS RD NE
ATLANTA, GA 303293102
Phone:
Type: Mailing
500 S Preston St Rm 305
Louisville, KY 402021702
Phone: (502) 852-8696
Type: Location
VCUHS DEPT OF PEDIATRIC RESIDENCY, 980264
1250 E. MARSHALL STREET
RICHMOND, VA 232980264
Phone:
Type: Mailing
3333 BURNET AVE, MLC 7022
CINCINNATI, OH 45229
Phone: (513) 636-4531
Fax: (513) 636-7407
Type: Mailing
3333 BURNET AVE
CINCINNATI, OH 45229
Phone: (513) 636-4531
Fax: (513) 636-7407
Type: Location
3333 Burnet Ave
Cincinnati, OH 45229
Phone: (513) 636-4531
Fax: (513) 636-7407
Type: Location
2174 N Druid Hills Rd NE
Atlanta, GA 303293102
Phone: (404) 785-5437
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2024-03-18 • Largest payer in this snapshot: Amgen Inc. ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Amgen Inc. | $20 |
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: 2025-09-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250930000404 | I | Nephrology | GA | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30329)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| Nephrology, Pediatric Medicine | GA | |
| Nurse Practitioner | GA | |
| N E P H R O L O G Y | LA | |
| Infectious Disease | IN | |
| Nurse Practitioner | GA | |
| N E P H R O L O G Y | MO | |
| - | GA | |
| N E P H R O L O G Y | GA | |
| Pediatric Medicine, Infectious Disease | GA |
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