Active NPI
Ryan A Lucas, A.T.C.
- Athletic Trainer
- South Portland, ME
National Provider Identifier
1144218389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT190
- Practice address
- 100 Foden Rd
Suite 103 West
South Portland, ME 04106-2319 - Phone
- (207) 772-2625
- NPI assigned
- Oct 12, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT190 | ME | Primary |
Addresses
Primary practice location
100 Foden Rd
Suite 103 West
South Portland, ME 04106-2319
Mailing address
69 Euclid Ave
Portland, ME 04103-1200
Phone (207) 831-7540
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT190 | ME | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saco Bay Orthopaedic and Sports Physical Therapy, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Saco Bay Orthopaedic Sports & Physical Therapy
- Physical Therapy Clinic/Center
- Westbrook, ME
- NPI 1396312807
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144218389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69 EUCLID AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041031200",
"telephone_number": "207-831-7540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 FODEN RD",
"address_2": "SUITE 103 WEST",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041062319",
"telephone_number": "207-772-2625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "RYAN",
"middle_name": "A",
"credential": "A.T.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ME",
"license": "AT190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.