Individual provider Active NPI

Kathryn Louise Oliver Luckett, MD

  • Student in an Organized Health Care Education/Training Program
  • Birmingham, AL
National Provider Identifier
1124525464
Registry record updated Feb 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
510 20TH St S Ste 858
Birmingham, AL 35233-2028
Phone
(205) 934-5188
NPI assigned
Apr 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

510 20TH St S Ste 858
Birmingham, AL 35233-2028

Mailing address

510 20TH St S Ste 858
Birmingham, AL 35233-2028
Phone (205) 934-5188

Other practice location 1

817 Princeton Ave SW Ste 106
Birmingham, AL 35211-1340
Phone (205) 783-7663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220623000303 AL Practitioner - Dermatology 7810239118 Reassigns benefits to 1 organization
I20240812000420 LA Practitioner - Dermatology 7810239118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Calais Dermatology AssociatesGroup PAC ID 1052462413, 3 clinicians

Practice addresses (Care Compare)

5220 Flanders Dr
Baton Rouge, LA 70808-9112
Phone (225) 766-5151

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as group
Quality
83.52
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of skin lesions188
Removal or shaving of skin growth1-10
Skin biopsy43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Calais Dermatology Associates Dermatology CurrentSince Oct 1, 2024 Accepting new patients
DCLH, Inc. Dermatology CurrentSince Aug 1, 2022 Accepting new patients

Locations

3415 Independence Dr
Ste 200
Birmingham, AL 35209
Phone (205) 871-7332

5406 Highway 280
Ste A100
Hoover, AL 35242
Phone (205) 871-7332

5220 Flanders Dr
Baton Rouge, LA 70808
Phone (225) 766-3437

Interoperability endpoints

  • Direct secure messaging: kluckett@calaisdermatology.emadirect.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580601600000",
    "number": "1124525464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 20TH ST S STE 858",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352332028",
            "telephone_number": "205-934-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 20TH ST S STE 858",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352332028",
            "telephone_number": "205-934-5188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "817 Princeton Ave SW Ste 106",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352111340",
            "country_code": "US",
            "telephone_number": "205-783-7663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCKETT",
        "first_name": "KATHRYN",
        "middle_name": "LOUISE OLIVER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2020-02-02",
        "certification_date": "2020-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.