Individual provider Active NPI

Nicole Huckabee

  • Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1760453369
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
137973 Issued in MO
Practice address
1702 N Kingshighway St
Cape Girardeau, MO 63701-2122
Phone
(573) 339-0483
Fax
(573) 339-1876
NPI assigned
Jan 31, 2006
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 137973 MO Primary

Addresses

Primary practice location

1702 N Kingshighway St
Cape Girardeau, MO 63701-2122

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-3000

Other names 1

  • Nicole Lusk Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20080908000552 MO Practitioner - Nurse Practitioner 1456427897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians
Immediate Convenient Care LLCGroup PAC ID 0648313486, 23 clinicians

Practice addresses (Care Compare)

150 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

1702 N Kingshighway
Cape Girardeau, MO 63701-2122

1702 N Kingshighway St
Cape Girardeau, MO 63701-2122

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049

24 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
137973MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center CurrentSince Jul 1, 2016 Accepting new patients
Cape Laboratory & Pathology, LC Current Accepting new patients
Saint Francis Medical Center CurrentSince Jul 1, 2016 Accepting new patients
Ferguson Medical Group Rural Health Center Inc. Past Accepting new patients

Locations

3120 Independence St
Cape Girardeau, MO 63703
Phone (573) 240-8846

1702 N Kingshighway St
Cpe Girardeau, MO 63701
Phone (573) 339-0483

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

545 Broadridge Dr
Jackson, MO 63755
Phone (573) 243-1997

Interoperability endpoints

  • Direct secure messaging: nhuckabee10818@surescripts.sfmc.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1760453369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-3000",
            "fax_number": "573-331-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 N KINGSHIGHWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012122",
            "telephone_number": "573-339-0483",
            "fax_number": "573-339-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCKABEE",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "137973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "LUSK",
            "credential": "MSN, APRN, BC-FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.