KENDRA KAY HACKNEY (FNP) – General Practice Registered Nurse, NPI 1053612697
General Practice Registered Nurse
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
16,353 NURSE PRACTITIONER in CA
Provider Addresses for KENDRA KAY HACKNEY (FNP)
1275 8TH ST
ARCATA, CA 955215770
Phone: (707) 826-8633
Type: Mailing
1644 CENTRAL AVE
MCKINLEYVILLE, CA 955194342
Phone: (707) 839-3068
Fax: (707) 839-3827
Type: Location
2401 DEMERS AVE
GRAND FORKS, ND 58201
Phone: (701) 780-1891
Type: Mailing
1845 HWY 59 S, STE 800 - ALTRU CLINIC THIEF RIVER FALLS
THIEF RIVER FALLS, MN 567014336
Phone: (218) 681-7280
Fax: (218) 683-5227
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-03-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110408000689 | I | Nurse Practitioner | MN | TBD |
| I20240319000810 | I | Nurse Practitioner | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 27 | 21 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 22 | 19 | $0 |
| Q3014 | Telehealth originating site facility fee | 19 | 13 | $0 |
Insurance plans in this area (ZIP 95521)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| - | CA | |
| - | CA | |
| - | NC | |
| Nurse Practitioner | CA | |
| Clinical Social Worker | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| Family Practice, Obstetrics/Gynecology | CA | |
| Nurse Practitioner | CA |
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