Carol R Luckey, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

APN0000005691 Issued in TN

Practice address

120 E Church St
Lexington, TN 38351

Phone

(731) 968-0146

Fax

(731) 968-9398

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Jackson Family Clinic Inc

  • Family Nurse Practitioner
  • Jackson, TN
  • NPI 1235178518
  NPD (past)
• Professional Imaging of Tennessee

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Somerville, TN
  • NPI 1073569901
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1003858150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 11567",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38308",
            "telephone_number": "731-661-0086",
            "fax_number": "731-660-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E CHURCH ST",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "38351",
            "telephone_number": "731-968-0146",
            "fax_number": "731-968-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKEY",
        "first_name": "CAROL",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "APN0000005691",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN5691",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEMPHIS MANAGED CARE (TLC",
            "identifier": "0000000031363",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "156102",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39006861",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "4157526",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3900686",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN CARE SELECT",
            "identifier": "4083540",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "4083540",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lincare Inc (United Medical)
• Courtney Lindsey
• Crystal Livingston
• Natasha Mae Loftin
• Brandi La'Shelle Long, O.D.
• Jeffrey Lundy, M.D.
• Jacob McKinley Maness
• Melinda S Maranto, NP-C
• Nathan Martz
• Douglas R Mays, SLP/CCC

• Primary Care Nurse Practitioner in Lexington, TN
• Providers in Lexington, TN by specialty
• Primary Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.