Individual provider Active NPI

Doris Ann Luce, LPN

  • Licensed Practical Nurse
  • Baldwinsville, NY
National Provider Identifier
1174756829
Registry record updated Aug 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
294854-1 Issued in NY
Practice address
8574 Sumac Dr
21-2E
Baldwinsville, NY 13027-1468
Phone
(315) 720-2105
NPI assigned
Aug 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 294854-1 NY Primary

Addresses

Primary practice location

8574 Sumac Dr
21-2E
Baldwinsville, NY 13027-1468

Mailing address

8574 Sumac Dr
21-2E
Baldwinsville, NY 13027-1468
Phone (315) 720-2105

Other names 1

  • Miss Doris Ann Clarke Former name

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

LicenseStateTypeSpecialty
294854-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1174756829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8574 SUMAC DR",
            "address_2": "21-2E",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130271468",
            "telephone_number": "315-720-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8574 SUMAC DR",
            "address_2": "21-2E",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130271468",
            "telephone_number": "315-720-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCE",
        "first_name": "DORIS",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-28",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "294854-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DORIS",
            "last_name": "CLARKE",
            "middle_name": "ANN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baldwinsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.