NPIMap

Organization Active NPI

Dr. Jeanvickey Lusk, M.D. & Co. P.C.

  • Family Medicine Physician
  • King of Prussia, PA
National Provider Identifier
1184020174
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5800 Issued in AL
Legal business name
DR. JEANVICKEY LUSK, M.D. & CO. P.C.
Practice address
315 Gypsy Lane
King of Prussia, PA 19406
Phone
(215) 200-8447
NPI assigned
Nov 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Authorized official

Name
Dr. Jeanvickey Lusk, M.D., M.D.NPI 1083077523
Title
Owner
Phone
(215) 200-8447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 5800 AL Primary

Addresses

Primary practice location

315 Gypsy Lane
King of Prussia, PA 19406

Mailing address

P.O. Box 60940
King of Prussia, PA 19406

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1184020174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 60940",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "19406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 GYPSY LANE",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "19406",
            "telephone_number": "215-200-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JEANVICKEY LUSK, M.D. & CO. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-18",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "LUSK, M.D.",
        "authorized_official_first_name": "JEANVICKEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-200-8447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "5800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.