Active NPI
Gary R Hackney, PH.D.
- Clinical Psychologist
- Wichita, KS
National Provider Identifier
1952402471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0375
- Practice address
- 7701 E Kellogg Dr
Ste 840
Wichita, KS 67207-1706 - Phone
- (316) 683-8668
- Fax
- (316) 683-4587
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0375 | KS | Primary |
Addresses
Primary practice location
7701 E Kellogg Dr
Ste 840
Wichita, KS 67207-1706
Mailing address
7701 E Kellogg Dr
Suite 640
Wichita, KS 67207-1706
Phone (316) 683-8668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061214000148 | KS | Practitioner - Clinical Psychologist | 3476543257 | Practice locations: Wichita, KS |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- University of North Dakota School of Medicine, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
12828 E 13TH St N
Suite 5
Wichita, KS 67230-1463
Phone (316) 683-8668
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0375 | KS | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542067200000",
"number": "1952402471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7701 E KELLOGG DR",
"address_2": "SUITE 640",
"city": "WICHITA",
"state": "KS",
"postal_code": "672071706",
"telephone_number": "316-683-8668",
"fax_number": "316-683-4587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7701 E KELLOGG DR",
"address_2": "STE 840",
"city": "WICHITA",
"state": "KS",
"postal_code": "672071706",
"telephone_number": "316-683-8668",
"fax_number": "316-683-4587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKNEY",
"first_name": "GARY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2018-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "0375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.