Active NPI
John R Lucas Jr., D.O.
- Emergency Medicine Physician
- Roanoke, VA
National Provider Identifier
1093776643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 0102201280
- Practice address
- 1906 Belleview Ave SE
Roanoke, VA 24014-1838 - Phone
- (540) 981-7000
- Fax
- (540) 981-9550
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 0102201280 | VA | Primary |
Addresses
Primary practice location
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Mailing address
PO Box 2080
Kilmarnock, VA 22482-2080
Phone (804) 435-3508
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005874904 | Medicaid | VA | |
| 005874912 | Medicaid | VA | |
| 010049628 | Medicaid | VA | |
| 010093619 | Medicaid | VA | |
| 010108675 | Medicaid | VA | |
| 010049024 | Medicaid | VA |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211241600000",
"number": "1093776643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2080",
"city": "KILMARNOCK",
"state": "VA",
"postal_code": "224822080",
"telephone_number": "804-435-3508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1906 BELLEVIEW AVE SE",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240141838",
"telephone_number": "540-981-7000",
"fax_number": "540-981-9550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "JOHN",
"middle_name": "R",
"name_suffix": "Jr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2008-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "VA",
"license": "0102201280",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005874904",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005874912",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010049628",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010093619",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010108675",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010049024",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.