Individual provider Active NPI

Dena Kaye Hibbs, APRN

  • Nurse Practitioner
  • De Queen, AR
National Provider Identifier
1770173536
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
214566 Issued in AR
Practice address
1553 W Collin Raye Dr
De Queen, AR 71832-3801
Phone
(870) 584-3000
Fax
(870) 584-3003
NPI assigned
Jan 25, 2021
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 214566 AR Primary

Addresses

Primary practice location

1553 W Collin Raye Dr
De Queen, AR 71832-3801

Mailing address

PO Box 740
De Queen, AR 71832-0740
Phone (870) 584-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL WWW.SHAREARKANSAS.COM Health Information Exchange (HIE) Randy D. Walker, M.D., P.L.L.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20210304002047 AR Practitioner - Nurse Practitioner 4587070248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Randy D Walker, MD, PLLCGroup PAC ID 0345468724, 9 clinicians

Practice addresses (Care Compare)

1553 W Collin Raye Dr
De Queen, AR 71832-3801
Phone (870) 584-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Randy D. Walker, M.D., P.L.L.C. Single Specialty CurrentSince Feb 2, 2021 Accepting new patients

Locations

1014 W Collin Raye Dr
De Queen, AR 71832
Phone (580) 286-2947

221 Main Ave
Dierks, AR 71833
Phone (870) 584-3000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEFHCA

Organizations & group practices 1

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 2

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": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1770173536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718320740",
            "telephone_number": "870-584-3000",
            "fax_number": "870-584-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1553 W COLLIN RAYE DR",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718323801",
            "telephone_number": "870-584-3000",
            "fax_number": "870-584-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBS",
        "first_name": "DENA",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "214566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.SHAREARKANSAS.COM",
            "affiliation": "Y",
            "endpointDescription": "WEB BASED APPLICATION",
            "affiliationName": "Randy D. Walker, M.D., P.L.L.C.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1553 W Collin Raye Dr",
            "city": "DE Queen",
            "state": "AR",
            "country_code": "US",
            "postal_code": "718323801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in De Queen, AR

Sources for this page

Verify at the official NPI Registry.