ANDREA M HUMPHREY (M.D.) – Family Medicine Physician, NPI 1265626105
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,037 FAMILY PRACTICE in IL
Loading map...
Provider Addresses for ANDREA M HUMPHREY (M.D.)
PO BOX 19639
SPRINGFIELD, IL 627949639
Phone: (217) 545-7578
Fax: (217) 545-1884
Type: Mailing
305, West Jackson Street, Carbondale, Jackson County, Illinois, 62901, United States
STE 200
CARBONDALE, IL 629011474
Phone: (618) 453-3777
Fax: (618) 453-1102
Type: Location
529 MEDICAL DR
LIVINGSTON, TN 385701880
Phone: (931) 823-9970
Fax: (931) 823-9006
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $35.
Total Amount is formed as General ($35) + Research ($0) + Ownership ($0) = $35.
Last reported payment date: 2024-11-14 • Largest payer in this snapshot: Exeltis, USA Inc. ($35).
Total Amount
$35
General + Research + Ownership
Payments
2
Total payment records
General Amount
$35
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Exeltis, USA Inc. | $35 |
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: 2023-10-12
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 |
|---|---|---|---|---|
| I20231012002743 | I | Family Practice | TN | 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 62794)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TN | |
| Nurse Practitioner | TN | |
| Internal Medicine | TN | |
| Internal Medicine | TN | |
| Nurse Practitioner | TN | |
| - | TN | |
| Nurse Practitioner | TN | |
| General Surgery | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IN | |
| Internal Medicine | TN |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.