NPIMap

Individual provider Active NPI

Rebecca Ann Lusk, C.P.N.P.

  • Pediatric Nurse Practitioner
  • Commerce City, CO
National Provider Identifier
1063568798
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
109578 Issued in CO
Practice address
4675 E 69TH Ave
Commerce City, CO 80022-2343
Phone
(303) 289-1086
Fax
(303) 289-7378
NPI assigned
Jan 26, 2007
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 109578 CO Primary

Addresses

Primary practice location

4675 E 69TH Ave
Commerce City, CO 80022-2343

Mailing address

3078 S Hobart Way
Denver, CO 80227-3823
Phone (303) 882-9608

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CommerceCity@KFHC.ssdirect.aprima.com Direct

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
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
109578COMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kids First Health Care Past Accepting new patients
Kids First Health Care Past Accepting new patients
Kids First Health Care Past Accepting new patients
Kids First Health Care Past Accepting new patients
Kids First Health Care Past Accepting new patients
Kids First Health Care Past Accepting new patients
Kids First Health Care Past Accepting new patients
Kids First Health Care Past Accepting new patients

Organizations & group practices 8

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1063568798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3078 S HOBART WAY",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802273823",
            "telephone_number": "303-882-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4675 E 69TH AVE",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "800222343",
            "telephone_number": "303-289-1086",
            "fax_number": "303-289-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSK",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "109578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CommerceCity@KFHC.ssdirect.aprima.com",
            "affiliation": "N",
            "endpointDescription": "Kids First Health Care Rebecca Lusk Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "4675 E 69th Ave",
            "city": "Commerce City",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800222343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Commerce City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.