Kenneth J Lucas, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME22441 Issued in FL

Practice address

405 N Clyde Morris Blvd
405 N Clyde Morris Blvd
Daytona Beach, FL 32114-2730

Phone

(386) 257-1626

Fax

(386) 254-7507

NPI assigned

Sep 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Metcare of Florida, Inc

  • Internal Medicine Physician
  • Port Orange, FL
  • NPI 1619433869
  NPD (past)
• Metcare of Florida, Inc

  • Internal Medicine Physician
  • Hialeah, FL
  • NPI 1902893225
  NPD (past)

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

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1023110665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142730",
            "telephone_number": "386-257-1626",
            "fax_number": "386-254-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N CLYDE MORRIS BLVD",
            "address_2": "405 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142730",
            "telephone_number": "386-257-1626",
            "fax_number": "386-254-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-03",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME22441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Mark Lowe, LMT
• Gregory M Lower, D.O.
• Benjamin Rex Tewhiti Lowry, PSY.D.
• Kelcey Theodore Lowry Jr.
• Marvin Louis Roy Yap Lu, MD
• Lindsay T Lucas, MD
• Lucent Health, LLC
• Lani Ellen Luers, ATC
• Matthew Luers, A.T.,C.
• Blanca Cristina Luna, M.D.

• Family Medicine Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.