Individual provider Active NPI

Courtney Augusta Lukitsch, MD

  • Psychiatry Physician
  • Charleston, SC
National Provider Identifier
1023748712
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
LL88167 Issued in SC
Practice address
169 Ashley Avenue
Room 202 Main Hospital, Msc333
Charleston, SC 29425
Phone
(843) 792-9162
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X LL88167 SC Primary

Addresses

Primary practice location

169 Ashley Avenue
Room 202 Main Hospital, Msc333
Charleston, SC 29425

Mailing address

169 Ashley Avenue
Room 202 Main Hospital, Msc333
Charleston, SC 29425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20221121001832 SC Order and Referring Only - PsychiatryPractitioner - Psychiatry 9133597206

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL88167SCMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1023748712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL, MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL, MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKITSCH",
        "first_name": "COURTNEY",
        "middle_name": "AUGUSTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "LL88167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.