Individual provider Active NPI

Cameron Lauckner, QBHP

  • Case Manager/Care Coordinator
  • Clarksville, AR
National Provider Identifier
1467060947
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
200 E Main St
Clarksville, AR 72830-3724
Phone
(479) 705-1634
Fax
(479) 705-1635
NPI assigned
Jul 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X AR Primary

Addresses

Primary practice location

200 E Main St
Clarksville, AR 72830-3724

Mailing address

104 Lock and Dam Rd
Russellville, AR 72802-9725
Phone (479) 747-5222

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

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1467060947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 LOCK AND DAM RD",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728029725",
            "telephone_number": "479-747-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E MAIN ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303724",
            "telephone_number": "479-705-1634",
            "fax_number": "479-705-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUCKNER",
        "first_name": "CAMERON",
        "credential": "QBHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-21",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; 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.