Active NPI
Lakesha Luckett
- Adult Medicine Physician
- Oak Creek, WI
National Provider Identifier
1063223626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- 0020376
- Practice address
- 2330 E Chestnut Dr
Oak Creek, WI 53154-1614 - Phone
- (414) 397-2528
- NPI assigned
- Jan 14, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 0020376 | WI | Primary |
Addresses
Primary practice location
2330 E Chestnut Dr
Oak Creek, WI 53154-1614
Mailing address
2330 E Chestnut Dr
Oak Creek, WI 53154-1614
Phone (414) 397-2528
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0020376 | WI | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736812800000",
"number": "1063223626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2330 E CHESTNUT DR",
"city": "OAK CREEK",
"state": "WI",
"postal_code": "531541614",
"telephone_number": "414-397-2528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2330 E CHESTNUT DR",
"city": "OAK CREEK",
"state": "WI",
"postal_code": "531541614",
"telephone_number": "414-397-2528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCKETT",
"first_name": "LAKESHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-14",
"last_updated": "2025-01-14",
"certification_date": "2025-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "WI",
"license": "0020376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Creek, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.