Individual provider Active NPI

Carla Ann Huckabee, CNM

  • Advanced Practice Midwife
  • Jonesboro, AR
National Provider Identifier
1548339567
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
MO1020 Issued in AR
Practice address
800 S Church St
Suite 202
Jonesboro, AR 72401-4176
Phone
(870) 934-8808
Fax
(870) 268-8400
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X MO1020 AR Primary

Addresses

Primary practice location

800 S Church St
Suite 202
Jonesboro, AR 72401-4176

Mailing address

1001 Oakland Dr
Paragould, AR 72450-4870
Phone (870) 236-9637

Other identifiers 1

IdentifierTypeStateIssuer
158095799MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070319000102 TX Practitioner - Certified Nurse Midwife (CNM) 2961437033 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MO1020ARMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Mar 29, 2017 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Mar 29, 2017 Accepting new patients
Choctaw Nation of Oklahoma Past Accepting new patients

Locations

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

Interoperability endpoints

  • Direct secure messaging: chuckabee19346@choctawnation.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548339567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 OAKLAND DR",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504870",
            "telephone_number": "870-236-9637",
            "fax_number": "870-236-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CHURCH ST",
            "address_2": "SUITE 202",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014176",
            "telephone_number": "870-934-8808",
            "fax_number": "870-268-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCKABEE",
        "first_name": "CARLA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AR",
            "license": "MO1020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158095799",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.