Individual provider Active NPI

Lucas Forrest Sheridan, DO

  • Vascular & Interventional Radiology Physician
  • Chapel Hill, NC
National Provider Identifier
1124778998
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
2025-00633 Issued in NC
Practice address
101 Manning Dr
Chapel Hill, NC 27514-4220
Phone
(984) 974-1000
NPI assigned
Mar 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X DO.3370 AL
Student in an Organized Health Care Education/Training Program 390200000X
Vascular & Interventional Radiology Physician 2085R0204X 2025-00633 NC Primary

Addresses

Primary practice location

101 Manning Dr
Chapel Hill, NC 27514-4220

Mailing address

1970 Redpine Dr
Semmes, AL 36575-7377
Phone (865) 679-3181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20250709003377 NC Order and Referring Only - Interventional RadiologyPractitioner - Interventional Radiology 3779964440

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025-00633NCMDVascular & Interventional Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1124778998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 REDPINE DR",
            "city": "SEMMES",
            "state": "AL",
            "postal_code": "365757377",
            "telephone_number": "865-679-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "984-974-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "LUCAS",
        "middle_name": "FORREST",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-25",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "DO.3370",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NC",
            "license": "2025-00633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.