Individual provider Active NPI

Christine Renee Hauck, APRN

  • Family Nurse Practitioner
  • Yukon, OK
National Provider Identifier
1669690269
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
79042 Issued in OK
Practice address
4400 Grant Blvd
Yukon, OK 73099
Phone
(405) 603-4660
Fax
(405) 470-3377
NPI assigned
Apr 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 0079042 OK
Pediatric Clinical Nurse Specialist 364SP0200X 0079042 OK
Family Nurse Practitioner 363LF0000X 79042 OK Primary

Addresses

Primary practice location

4400 Grant Blvd
Yukon, OK 73099

Mailing address

11200 Lerida LN
Oklahoma City, OK 73173-8158
Phone (405) 314-5266

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150205000252 OK Practitioner - Nurse Practitioner 8527383082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Physicians Group, LLCGroup PAC ID 8325950603, 107 clinicians

Practice addresses (Care Compare)

10021 S Western Ave
Oklahoma City, OK 73139-2927
Phone (405) 692-9300

12928 N May Ave
Oklahoma City, OK 73120-0817
Phone (405) 470-6510

1616 S Kelly Ave
Edmond, OK 73013-3651
Phone (405) 330-0032

4400 Grant Blvd
Yukon, OK 73099-0037
Phone (405) 787-8550

4400 Grant Blvd
Suite 103
Yukon, OK 73099-0038
Phone (405) 787-8550

Hospital & facility affiliations

  • A Path of Care Home Health III, Inc Home health agency, Yukon, OK, CCN 377448
  • Amedisys Home Health Home health agency, Oklahoma City, OK, CCN 377642
  • Apex Home Health Home health agency, Oklahoma City, OK, CCN 377709
  • Best Choice Home Health Inc Home health agency, Oklahoma City, OK, CCN 377764
  • Elara Caring XX Home health agency, Oklahoma City, OK, CCN 377648
  • Norman Regional Hospital, Norman, OK, CCN 370008
  • Baptist Village of Oklahoma City Nursing home, Oklahoma City, OK, CCN 375381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
79042OKMDFamily Nurse Practitioner
0079042OKMDPediatric Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Physicians Group LLC CurrentSince Sep 1, 2016 Accepting new patients
Mercy Hospital Kingfisher, Inc Past Accepting new patients

Locations

7530 NW 23rd St
Bethany, OK 73008
Phone (405) 730-6990

10021 S Western Ave
Oklahoma City, OK 73139
Phone (405) 692-9300

4400 Grant Blvd
Yukon, OK 73099
Phone (405) 467-4440

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1669690269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 LERIDA LN",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731738158",
            "telephone_number": "405-314-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 GRANT BLVD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "73099",
            "telephone_number": "405-603-4660",
            "fax_number": "405-470-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUCK",
        "first_name": "CHRISTINE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-22",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "OK",
            "license": "0079042",
            "primary": false
        },
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "OK",
            "license": "0079042",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "79042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.