James Edwin Luckie Jr., D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19720 Issued in GA

Practice address

182 Perry House Rd
Suite E
Fitzgerald, GA 31750-8721

Phone

(229) 423-8725

Fax

(229) 423-8726

NPI assigned

Aug 9, 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

General Practice

Education

Philadelphia College of Osteopathic Medicine, 1977

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Tifton, GA, CCN 117077
• Georgia Home Health Services Home health agency, Valdosta, GA, CCN 117058
• Dorminy Medical Center Hospital, Fitzgerald, GA, CCN 110073
• Dorminy Medical Center Hospital, Fitzgerald, GA, CCN 111339

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Marie Luckie, FNP-C

  • Family Nurse Practitioner
  • Fitzgerald, GA
  • NPI 1134600414
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Georgia, L.L.C.

  • Home Health Agency
  • Tifton, GA
  • NPI 1356524359
  Care Compare affiliation
• GHHS Healthcare, LLC

  • Home Health Agency
  • Valdosta, GA
  • NPI 1114174992
  Care Compare affiliation
• Hospital Authority of Ben Hill

  • Critical Access Hospital
  • Fitzgerald, GA
  • NPI 1245248624
  Care Compare affiliation

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1093725079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1349",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317501349",
            "telephone_number": "229-423-8725",
            "fax_number": "229-423-8726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 PERRY HOUSE RD",
            "address_2": "SUITE E",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508721",
            "telephone_number": "229-423-8725",
            "fax_number": "229-423-8726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKIE",
        "first_name": "JAMES",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "19720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000153821A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "581331734",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsie Nicole King
• Sandra Larkin, CCC-SLP
• Larry E Forth O D P C
• Samantha Leyse
• LF SNF LLC
• Lisa Marie Luckie, FNP-C
• Robert A Ludwick, MD
• Warren Manley
• Thomas R Mann, M.D.PC
• Wayne S Maris, DDS

• Family Medicine Physician in Fitzgerald, GA
• Providers in Fitzgerald, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.