Kendra Kay Hackney, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95027800 Issued in CA

Practice address

1644 Central Ave
McKinleyville, CA 95519-4342

Phone

(707) 839-3068

Fax

(707) 839-3827

NPI assigned

Nov 13, 2010

Last updated

Aug 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Open Door Community Health CentersGroup PAC ID 9436067485, 113 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence at Home With Compassus Home Health, Humboldt Home health agency, Eureka, CA, CCN 057256
• Mad River Community Hospital Hospital, Arcata, CA, CCN 050028
• Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khackney683225@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Open Door Community Health Centers

  dba Del Norte Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Crescent City, CA
  • NPI 1497840656
  Medicare reassignment Care Compare group NPD
• Lifecare Medical Center

  • Critical Access Hospital
  • Roseau, MN
  • NPI 1609861095
  Medicare reassignment NPD
• Open Door Community Health Centers

  dba McKinleyville Community Health Center

  • Federally Qualified Health Center (FQHC)
  • McKinleyville, CA
  • NPI 1598858169
  NPD
• Open Door Community Health Centers

  dba Open Door Downtown

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
  • NPI 1831713452
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• American Hospital Management Corporation

  dba Mad River Community Hospital

  • General Acute Care Hospital
  • Arcata, CA
  • NPI 1518996040
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Humboldt Home Infusion

  • Home Infusion Therapy Pharmacy
  • Eureka, CA
  • NPI 1568422319

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1891900635
  Care Compare affiliation
• St. Joseph Home Care Network

  dba Providence Home Health Humboldt

  • Home Health Agency
  • Eureka, CA
  • NPI 1144315052
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1053612697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 8TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215770",
            "telephone_number": "707-826-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 CENTRAL AVE",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955194342",
            "telephone_number": "707-839-3068",
            "fax_number": "707-839-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKNEY",
        "first_name": "KENDRA",
        "middle_name": "KAY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-13",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027800",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "95354760",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "F0910261",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP2597",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Nicole Goodman
• Lindsey D Goodnow, DAOM, L.AC.
• Nina Bleue Goodwin, F.N.P.
• Laura Guerra, F.N.P.
• Sarah Catherine Haag, PH.D.
• Sacha Briana Hall, PA
• Paula Jean Hansel Allen, PA-C
• John Tim Haskett, G.N.P.
• Health Care Medical Assoc
• Dianna Heimstadt, LCSW

• Family Nurse Practitioner in McKinleyville, CA
• Providers in McKinleyville, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.