Active NPI
Halley M Barke, PAC
- Physician Assistant
- Anna, IL
National Provider Identifier
1669612438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.003421
- Practice address
- 513 N Main St
Anna, IL 62906-1668 - Phone
- (618) 833-4471
- Fax
- (618) 833-6267
- NPI assigned
- Mar 5, 2009
- Last updated
- Apr 25, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.003421 | IL | Primary |
Addresses
Primary practice location
513 N Main St
Anna, IL 62906-1668
Mailing address
513 N Main St
Anna, IL 62906-1668
Phone (618) 833-4471
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110826000733 | IL | Order and Referring Only - Physician Assistant | 2466621768 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.003421 | IL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461542400000",
"number": "1669612438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "513 N MAIN ST",
"city": "ANNA",
"state": "IL",
"postal_code": "629061668",
"telephone_number": "618-833-4471",
"fax_number": "618-833-6267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "513 N MAIN ST",
"city": "ANNA",
"state": "IL",
"postal_code": "629061668",
"telephone_number": "618-833-4471",
"fax_number": "618-833-6267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARKE",
"first_name": "HALLEY",
"middle_name": "M",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-05",
"last_updated": "2016-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.003421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anna, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.