Individual provider Active NPI

Braidi Rose Huecker, M.D.

  • Obstetrics & Gynecology Physician
  • New Albany, IN
National Provider Identifier
1205053725
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01069787A Issued in IN
Practice address
1919 State St Ste 340
New Albany, IN 47150-6807
Phone
(812) 945-5233
Fax
(812) 945-2804
NPI assigned
Apr 18, 2007
Last updated
Nov 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Obstetrics & Gynecology Physician 207V00000X 01069787A IN Primary

Addresses

Primary practice location

1919 State St Ste 340
New Albany, IN 47150-6807

Mailing address

1919 State St Ste 340
New Albany, IN 47150-6807
Phone (812) 945-5233

Other identifiers 1

IdentifierTypeStateIssuer
201037020AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01069787AINMDObstetrics & Gynecology Physician

Interoperability endpoints

  • Direct secure messaging: braidihuecker@obgasi.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1205053725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 STATE ST STE 340",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471506807",
            "telephone_number": "812-945-5233",
            "fax_number": "812-945-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 STATE ST STE 340",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471506807",
            "telephone_number": "812-945-5233",
            "fax_number": "812-945-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUECKER",
        "first_name": "BRAIDI",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01069787A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201037020A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.