DR. WILLIAM T JR. HUMPHREY (MD) – Family Medicine Physician, NPI 1699765693
Family Medicine Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. WILLIAM T JR. HUMPHREY (MD)
1600 Vernon Rd
Suite G
LaGrange, GA 302404143
Phone: (706) 880-7366
Fax: (706) 880-7299
Type: Location
309, Holly Lane, High Ciara, Mankato, Blue Earth County, Minnesota, 56001, United States
MANKATO, MN 560015422
Phone: (507) 388-2120
Type: Mailing
203 S Western Ave
Tonasket, WA 988558803
Phone: (509) 486-2151
Fax: (509) 486-3176
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2020-02-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20160330002666 | I | Family Practice | GA | TBD |
| I20200207001558 | I | Family Practice | WA | 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 30240)
Loading plans...
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.