Trevor Huckaby
Individual provider Active NPI Family Nurse Practitioner · Caryville, TN
NPI 1447878699 · NPPES record last updated Oct 12, 2021
Key facts
- NPI
- 1447878699
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APN29141 (TN)
- Practice address
- 140 John McGhee Blvd
Caryville, TN 37714-3155 - Phone
- (865) 647-3230
- Fax
- (423) 562-3591
- NPI assigned
- Jul 13, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210428001684 | TN | Practitioner - Nurse Practitioner | 6507274784 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN29141 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients |
Locations
300 Montvue Rd
Knoxville, TN 37919
Phone (818) 613-6769
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Interoperability endpoints
- trevor.huckaby.1@4694.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APN29141 | TN | Yes |
Addresses
Primary practice location
140 John McGhee Blvd
Caryville, TN 37714-3155
Mailing address
140 John McGhee Blvd
Caryville, TN 37714-3155
Phone (865) 647-3230
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | trevor.huckaby.1@4694.direct.athenahealth.com |
Other providers in Caryville, TN
- Bio-Medical Applications of Tennessee, Inc.
- Campbell County Hma LLC
- Dci of East Tennessee LLC
- Dialysis Clinic Inc
- Katherine Paige Freeman
- Chelsey Nicole Kuper
- Emily Nicole Lynch
- Kayla Elizabeth Lynch
- Shaun Paul Lynch
- Rebecca Peterson
All providers in Caryville, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.