KENDRA KAY HACKNEY FNP
NPI 1053612697
Nurse Practitioner - Family in Mckinleyville, CA
About Kendra Kay Hackney Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENDRA KAY HACKNEY FNP (NPI 1053612697) is an individual family provider in Mckinleyville, California, licensed in California (95027800) and active in the NPI registry since November 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2010).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kendra Kay Hackney Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Kendra Hackney reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Mckinleyville, CA 95519
- Reassigned Medicare billing, California enrollment
- 175 clinicians in this Medicare group
Roseau, MN 56751
- Reassigned Medicare billing, Minnesota enrollment
- 89 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95519 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kendra Hackney's NPI number?
The NPI number for Kendra Hackney is 1053612697. It was assigned to this individual provider in the NPPES registry on November 13, 2010.
Where is Kendra Hackney located?
Kendra Hackney practices at 1644 Central Ave, Mckinleyville, CA 95519. The listed phone number is (707) 839-3068.
What is Kendra Hackney's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kendra Hackney enrolled in Medicare?
Yes. Kendra Hackney is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kendra Hackney's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kendra Hackney reassigns Medicare benefits to 2 organizations: Open Door Community Health Centers (Mckinleyville, CA) and Lifecare Medical Center (Roseau, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kendra Hackney's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kendra Hackney was last updated on August 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kendra Kay Hackney, FNP · NPI 1053612697
Family physician in Mckinleyville, California. Individual provider, active in the CMS NPPES registry since November 13, 2010.
## Identity
- **NPI:** 1053612697 (Entity type: Individual)
- **Enumerated:** November 13, 2010
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95027800 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1644 CENTRAL AVE, Mckinleyville, CA 95519-4342
- **Phone:** (707) 839-3068 · **Fax:** (707) 839-3827
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Open Door Community Health Centers (NPI 1598858169, Mckinleyville, CA); Lifecare Medical Center (NPI 1609861095, Roseau, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2010
## Record status
- **NPPES last updated:** August 29, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1053612697) · Data from the CMS NPPES public registry.