Individual provider Active NPI

Jane Daugherty-Luck, DO

  • Emergency Medicine Physician
  • Hays, KS
National Provider Identifier
1003880725
Registry record updated Mar 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
05-26967 Issued in KS
Practice address
2220 Canterbury Dr
Hays, KS 67601-2370
Phone
(785) 623-5555
Fax
(785) 623-5518
NPI assigned
Feb 17, 2006
Last updated
Mar 26, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 05-26967 KS Primary

Addresses

Primary practice location

2220 Canterbury Dr
Hays, KS 67601-2370

Mailing address

2220 Canterbury Dr
Hays, KS 67601-2370
Phone (785) 623-5555

Other identifiers 1

IdentifierTypeStateIssuer
100425560AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090527000434 OH Practitioner - Emergency Medicine 0345277547 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
05-26967KSMDEmergency Medicine Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238025600000",
    "number": "1003880725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 CANTERBURY DR",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676012370",
            "telephone_number": "785-623-5555",
            "fax_number": "785-623-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 CANTERBURY DR",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676012370",
            "telephone_number": "785-623-5555",
            "fax_number": "785-623-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY-LUCK",
        "first_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2009-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "05-26967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100425560A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hays, KS

Sources for this page

Verify at the official NPI Registry.