Individual provider Active NPI

Jose Encarnacion Lucio

  • Other Technician
  • Hurlburt Field, FL
National Provider Identifier
1003044900
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
113 Lielmanis Ave
Hurlburt Field, FL 32544-5613
Phone
(850) 881-5855
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Primary

Addresses

Primary practice location

113 Lielmanis Ave
Hurlburt Field, FL 32544-5613

Mailing address

113 Lielmanis Ave
Hurlburt Field, FL 32544-5613
Phone (850) 881-5855

Other identifiers 1

IdentifierTypeStateIssuer
247200000XOtherIDMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1003044900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 LIELMANIS AVE",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "325445613",
            "telephone_number": "850-881-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 LIELMANIS AVE",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "325445613",
            "telephone_number": "850-881-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIO",
        "first_name": "JOSE",
        "middle_name": "ENCARNACION",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDMT",
            "identifier": "247200000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurlburt Field, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.