W.a. Lucky LLC.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

A003800 Issued in AR

Legal business name

W.A. LUCKY LLC.

Practice address

1753 N College Ave
Ste. 100
Fayetteville, AR 72703-2650

Phone

(479) 442-5677

NPI assigned

Apr 2, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Larry Walker

Title

Owner

Phone

(479) 442-5677

Specialties & licenses 1

Addresses

Other names 1

• Acheive Medical Weightloss Other name

Locations

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364860800000",
    "number": "1194068734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 N COLLEGE AVE",
            "address_2": "STE. 100",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 N COLLEGE AVE",
            "address_2": "STE. 100",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032650",
            "telephone_number": "479-442-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.A. LUCKY LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-02",
        "last_updated": "2013-04-02",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-442-5677",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "AR",
            "license": "A003800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Acheive Medical Weightloss",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Health Maintenance Organization in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Health Maintenance Organization in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.