Kristina Lynn Huckeba, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APN0000029787 Issued in TN

Practice address

5302 Ball Camp Pike
Knoxville, TN 37921-3234

Phone

(865) 541-6958

NPI assigned

Jul 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Helen Ross McNabb Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Knoxville, TN
  • NPI 1659330686
  Medicare reassignment NPD
• Margaret Heffernan Bonifacio

  • Psychiatric/Mental Health Nurse Practitioner
  • Maryville, TN
  • NPI 1487096376
  NPD
• MJ Mental Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Knoxville, TN
  • NPI 1578348256
  NPD

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1780202028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TECH CENTER DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379122747",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5302 BALL CAMP PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379213234",
            "telephone_number": "865-541-6958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1252 Bill Wallace Dr",
            "address_purpose": "LOCATION",
            "city": "Friendsville",
            "state": "TN",
            "postal_code": "377372558",
            "country_code": "US",
            "telephone_number": "865-724-5694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 W 3rd North St",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "TN",
            "postal_code": "378144038",
            "country_code": "US",
            "telephone_number": "423-581-4761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUCKEBA",
        "first_name": "KRISTINA",
        "middle_name": "LYNN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "APN0000029787",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000187933",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q068411",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Claire Huber, PA-C
• Siham Mariah Hubi
• Hayden Huckaba, DDS
• Natalie Lyna Huckabee
• Alicia Danielle Huckaby, MS, NCC, LPC-MHSP
• Andrew Huddleston
• Carol Huddleston, RN
• Charles I Huddleston, MD
• Dewayne Huddleston, L.P.N.
• Patricia M Huddleston, NP

• Psychiatric/Mental Health Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; 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.

Verify at the official NPI Registry.