Nichole Megan Koebernik

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

205 East Highland Drive
Jonesboro, AR 72401

Phone

(800) 467-3278

NPI assigned

Jan 4, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nichole Megan Hagar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1437929064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E SPEEDWAY ST",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "724722329",
            "telephone_number": "501-426-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 EAST HIGHLAND DRIVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "800-467-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEBERNIK",
        "first_name": "NICHOLE",
        "middle_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "HAGAR",
            "middle_name": "MEGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Micah Knight, OT-A
• Seneca Knight
• Kenneth Knowlton, QBHP
• Whitney Knox
• Anna C Koch, PT
• Mandy Koekemoer
• Macie Koelling
• Jonathan Koh
• Savannah Kohler
• James M Kolarik, PHD

• Home Health Aide in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Home Health Aide in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.