Dr. Jessica Joy Humphrey, OD
Optometrist in Manchester, MI. Individual provider (NPI-1).
NPI number1265300511
StatusActive
Last updated in NPPESFeb 13, 2026
Details
- NPI
- 1265300511
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jessica Joy Humphrey
- Credential
- OD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 28, 2025
- Certification date
- Feb 13, 2026
- Last updated
- Feb 13, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPTOMETRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 4901005920 | MI | Yes |
Practice location
110 Riverside DrManchester, MI 48158-9776
Phone 734-428-2020 · Fax 734-428-8955
Mailing address
110 Riverside DrManchester, MI 48158-9776
Phone 734-428-2020 · Fax 734-428-8955
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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