Individual provider Active NPI

Mary Ellen Huckabee, CRNP

  • Nurse Practitioner
  • Grove Hill, AL
National Provider Identifier
1841240223
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1038498 Issued in AL
Practice address
295B S Jackson St
Grove Hill, AL 36451-3231
Phone
(251) 275-3173
Fax
(251) 275-4281
NPI assigned
May 10, 2006
Last updated
Mar 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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 1038498 AL Primary

Addresses

Primary practice location

295B S Jackson St
Grove Hill, AL 36451-3231

Mailing address

PO Box 935
Grove Hill, AL 36451-0935
Phone (251) 275-3173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20050204000790 AL Practitioner - Nurse Practitioner 2365493509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

295 B S Jackson St
Grove Hill, AL 36451-3231
Phone (251) 275-3173

297 S Jackson St
Grove Hill, AL 36451-3231
Phone (251) 275-2286

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1038498ALMDNurse Practitioner

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 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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1841240223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 935",
            "city": "GROVE HILL",
            "state": "AL",
            "postal_code": "364510935",
            "telephone_number": "251-275-3173",
            "fax_number": "251-275-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295B S JACKSON ST",
            "city": "GROVE HILL",
            "state": "AL",
            "postal_code": "364513231",
            "telephone_number": "251-275-3173",
            "fax_number": "251-275-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCKABEE",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1038498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove Hill, AL

Sources for this page

Verify at the official NPI Registry.