Stephanie N Luckett, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

9477 Issued in KY

Practice address

2215 Portland Ave
Louisville, KY 40212-1033

Phone

(502) 772-8160

Fax

(502) 772-8108

NPI assigned

Jul 24, 2014

Last updated

Aug 6, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie N Mitchell Former name

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• TN PPO C-SNP
• KY PPO C-SNP
• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BFEFCD/Endpoint/BFEFCD

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.

• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1649732603
  Medicare reassignment NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1104879469
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1134172489
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1205689064
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1205889540
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1578774477
  NPD
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fairdale, KY
  • NPI 1871546119
  NPD
• Family Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1942954441
  NPD (past)
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1356394670
  NPD (past)
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1427574862
  NPD (past)
• Family Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Louisville, KY
  • NPI 1518963230
  NPD (past)

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470441600000",
    "number": "1003224833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 PORTLAND AVENUE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402423214",
            "telephone_number": "502-772-8160",
            "fax_number": "502-772-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 PORTLAND AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402121033",
            "telephone_number": "502-772-8160",
            "fax_number": "502-772-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKETT",
        "first_name": "STEPHANIE",
        "middle_name": "N",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-24",
        "last_updated": "2016-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "MITCHELL",
            "middle_name": "N",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Makenzi Rose Luckett
• Margaret Dean Luckett, PT
• Margo Luckett, RN
• Meredith Kyle-Alvey Luckett, DPT
• Stephanie Luckett, PHARMD
• Theodore Luckey
• Val Luckyan
• Aundrea Renee Ludlow, RN
• Danielle Ludlum
• Caleb James Ludwig

• Dentist in Louisville, KY
• Providers in Louisville, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.