Active NPI
Luke Hubbard
- Certified Registered Nurse Anesthetist
- Cape Girardeau, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 110038
- Practice address
- 1701 Lacey St
Cape Girardeau, MO 63701-5230 - Phone
- (573) 651-5562
- Fax
- (573) 651-5868
- NPI assigned
- Jul 26, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2010003635 | MO | |
| Certified Registered Nurse Anesthetist | 367500000X | 110038 | MO | Primary |
Addresses
Primary practice location
1701 Lacey St
Cape Girardeau, MO 63701-5230
Mailing address
2059 Derwin Cir
Jackson, MO 63755-8551
Phone (573) 979-1491
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160224002701 | MO | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9537464847 | Reassigns benefits to 6 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone (573) 331-3000
Hospital & facility affiliations
- Saint Francis Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010003635 | MO | MD | Registered Nurse |
| 110038 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DPS Anesthesia, LLC | Current | Accepting new patients | |
| Missouri Delta Medical Center | Current | Accepting new patients | |
| ASC Anesthesia LLC | Current | Accepting new patients | |
| Saint Francis Medical Center | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Missouri Delta Medical Center | Current | Accepting new patients | |
| Resource Anesthesiology Associates of Mo LLC | Current | Accepting new patients | |
| Southeast Missouri Hospital Physicians, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Saint Francis Medical Center | Current | Accepting new patients | |
| Saint Francis Medical Center | Past | Accepting new patients |
Locations
1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822
211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000
300 S Mount Auburn Rd
Ste 200
Cpe Girardeau, MO 63703
Phone (573) 332-7881
30 Doctors Park
Cpe Girardeau, MO 63703
Phone (573) 334-9606
1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600
Organizations & group practices 9
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Cape Girardeau, MO
- NPI 1356304489
MO, Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Sikeston, MO
- NPI 1396116521
MO
-
- Family Medicine Physician
- Cape Girardeau, MO
- NPI 1558311522
MO, Nurse Anesthetist, Certified Registered
-
- Community/Retail Pharmacy
- Malden, MO
- NPI 1578371621
-
- Clinic/Center
- Jackson, MO
- NPI 1992502975
-
- Internal Medicine Physician
- Cape Girardeau, MO
- NPI 1578513016
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456617600000",
"number": "1265817779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2059 DERWIN CIR",
"city": "JACKSON",
"state": "MO",
"postal_code": "637558551",
"telephone_number": "573-979-1491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 LACEY ST",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637015230",
"telephone_number": "573-651-5562",
"fax_number": "573-651-5868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "LUKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-26",
"last_updated": "2016-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2010003635",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "110038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.