Individual provider Active NPI

Luke Hubbard

  • Certified Registered Nurse Anesthetist
  • Cape Girardeau, MO
National Provider Identifier
1265817779
Registry record updated Feb 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
110038 Issued in MO
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

Updated by the provider on Feb 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone (573) 331-3000

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2010003635MOMDRegistered Nurse
110038MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
DPS Anesthesia, LLC CurrentSince Jul 5, 2021 Accepting new patients
Missouri Delta Medical Center CurrentSince Nov 1, 2024 Accepting new patients
ASC Anesthesia LLC CurrentSince Mar 1, 2022 Accepting new patients
Saint Francis Medical Center Nurse Anesthetist, Certified Registered CurrentSince Mar 11, 2025 Accepting new patients
Missouri Delta Medical Center CurrentSince Nov 1, 2024 Accepting new patients
Resource Anesthesiology Associates of Mo LLC CurrentSince Feb 10, 2022 Accepting new patients
Southeast Missouri Hospital Physicians, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 11, 2016 Accepting new patients
Saint Francis Medical Center CurrentSince Mar 11, 2025 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.

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.

Verify at the official NPI Registry.