Individual provider Active NPI

Cailey Rae Anne Noonan

  • Family Nurse Practitioner
  • Norfolk, NE
National Provider Identifier
1679259766
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
114840 Issued in NE
Practice address
302 W Phillip Ave
Norfolk, NE 68701-5248
Phone
(402) 371-8000
NPI assigned
Jun 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 114840 NE Primary

Addresses

Primary practice location

302 W Phillip Ave
Norfolk, NE 68701-5248

Mailing address

302 W Phillip Ave
Norfolk, NE 68701-5248
Phone (402) 371-8000

Other names 1

  • Cailey Rae Anne Heavican Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230710003687 NE Practitioner - Family Practice 0042679912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midtown Health Center IncGroup PAC ID 9133110182, 14 clinicians

Practice addresses (Care Compare)

302 W Phillip Ave
Norfolk, NE 68701-5248
Phone (402) 370-1064

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
114840NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown Health Center, Inc. CurrentSince Jul 3, 2023 Accepting new patients
Midtown Health Center, Inc. CurrentSince Jul 3, 2023 Accepting new patients

Locations

210 S 3rd St
Norfolk, NE 68701

302 W Phillip Ave
Norfolk, NE 68701
Phone (402) 370-1064

303 Plaza Dr
West Point, NE 68788
Phone (402) 372-1034

Interoperability endpoints

  • Direct secure messaging: cailey.noonan.p1@direct.midtownhealthcenter.nextgenshare.com

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 1

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": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1679259766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W PHILLIP AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015248",
            "telephone_number": "402-371-8000",
            "fax_number": "402-371-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W PHILLIP AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015248",
            "telephone_number": "402-371-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "CAILEY",
        "middle_name": "RAE ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "114840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAILEY",
            "last_name": "HEAVICAN",
            "middle_name": "RAE ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.