Individual provider Active NPI

Jennifer M Lucas, ARNP

  • Family Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1275776841
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A143612 Issued in IA
Practice address
2710 Saint Francis Dr
#320
Waterloo, IA 50702-5619
Phone
(319) 272-5000
Fax
(319) 272-8072
NPI assigned
Apr 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95031 OK
Family Nurse Practitioner 363LF0000X A143612 IA Primary

Addresses

Primary practice location

2710 Saint Francis Dr
#320
Waterloo, IA 50702-5619

Mailing address

2710 Saint Francis Dr
#320
Waterloo, IA 50702-5619
Phone (319) 272-5000

Other identifiers 1

IdentifierTypeStateIssuer
200244510AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160901000072 IA Practitioner - Nurse Practitioner 6608926647 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A143612IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation CurrentSince Dec 19, 2022 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-7050

1776 Westlakes Pkwy
Ste 100
West Des Moines, IA 50266
Phone (515) 241-3510

6010 Mills Civic Pkwy
Ste 100
West Des Moines, IA 50266
Phone (515) 221-7800

Interoperability endpoints

  • Direct secure messaging: jlucas923993@direct.unitypoint.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1275776841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 SAINT FRANCIS DR",
            "address_2": "#320",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025619",
            "telephone_number": "319-272-5000",
            "fax_number": "319-272-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 SAINT FRANCIS DR",
            "address_2": "#320",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025619",
            "telephone_number": "319-272-5000",
            "fax_number": "319-272-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "95031",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A143612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200244510A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.