Tedford Clive Luck, M.D,

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20625 Issued in CO

Practice address

1055 Clermont St. 11B
Denver, CO 80220-0809

Phone

(303) 393-2839

Fax

(303) 393-4677

NPI assigned

Jul 10, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053345355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 CLERMONT ST. 11B",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802200809",
            "telephone_number": "303-393-2839",
            "fax_number": "303-393-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 CLERMONT ST. 11B",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802200809",
            "telephone_number": "303-393-2839",
            "fax_number": "303-393-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCK",
        "first_name": "TEDFORD",
        "middle_name": "CLIVE",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "20625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Marie Lucero, PH.D., LCSW
• Olivia Nicole Lucero
• Patricia Lucero
• Vickie Shane Lucero, LPC, LAC
• Amanda Rose Lucier, MD
• Alyssa M Lucker, DO
• Ann K. Luckey
• Cara Luckey, LSW
• Lucky You Adult Day Care, LLC
• Lucky You Home Care Services, LLC

• Internal Medicine Physician in Denver, CO
• Providers in Denver, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.