Individual provider Active NPI

Larae I Huycke, PMHNP-ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Galena, KS
National Provider Identifier
1851542682
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
53-83532-101 Issued in KS
Practice address
1220 E 8TH St
Galena, KS 66739-1865
Phone
(417) 658-9565
NPI assigned
Oct 10, 2008
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 741234 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61253183 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2024029050 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 53-83532-101 KS Primary

Addresses

Primary practice location

1220 E 8TH St
Galena, KS 66739-1865

Mailing address

4784 Oak St
Kansas City, MO 64112-2262
Phone (817) 991-5951

Other identifiers 1

IdentifierTypeStateIssuer
8Y8938OtherTXBLUE CROSS BLUE SHIELD

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
I20240806004000 MO Practitioner - Nurse Practitioner 0244394575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
98.74 of 100Reported as group
Quality
91.53
Improvement activities
40
Cost
73.77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-83532-101KSMDPsychiatric/Mental Health Nurse Practitioner
2024029050MOMDPsychiatric/Mental Health Nurse Practitioner
AP61253183WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vickery Health Center PastSince Oct 30, 2008 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1851542682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4784 OAK ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641122262",
            "telephone_number": "817-991-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E 8TH ST",
            "city": "GALENA",
            "state": "KS",
            "postal_code": "667391865",
            "telephone_number": "417-658-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYCKE",
        "first_name": "LARAE",
        "middle_name": "I",
        "credential": "PMHNP-ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-10",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "741234",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61253183",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2024029050",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "53-83532-101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8Y8938",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galena, KS

Sources for this page

Verify at the official NPI Registry.