Kelly Jo Lucas

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

292083 Issued in NC

Practice address

670 W Academy St
Randleman, NC 27317-9748

Phone

(336) 498-8500

Fax

(336) 498-8522

NPI assigned

Jan 12, 2024

Last updated

Sep 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

University of Alabama School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forsyth Medical Group, LLCGroup PAC ID 3678478054, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Randolph Hospital Hospital, Asheboro, NC, CCN 340123

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.lucas.1@32593.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Forsyth Medical Group, LLC

  dba Privia Medical Group - North Carolina

  • Obstetrics & Gynecology Physician
  • Hendersonville, NC
  • NPI 1750081378
  Medicare reassignment Care Compare group NPD (past)
• Randleman Medical Center

  • Primary Care Nurse Practitioner
  • Randleman, NC
  • NPI 1477810265
  Medicare reassignment NPD
• Forsyth Medical Group LLC

  dba Queen City Ear Nose and Throat

  • Otolaryngology Physician
  • Monroe, NC
  • NPI 1710866405
  NPD
• Forsyth Medical Group, LLC

  dba ReEnvision

  • Physical Therapist
  • Greensboro, NC
  • NPI 1043023138
  NPD
• Randleman Medical Center LLC

  • Primary Care Clinic/Center
  • Randleman, NC
  • NPI 1710920335
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• American Healthcare Systems, LLC

  • General Acute Care Hospital
  • Asheboro, NC
  • NPI 1942895081
  Care Compare affiliation

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1295506798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 W ACADEMY ST",
            "city": "RANDLEMAN",
            "state": "NC",
            "postal_code": "273179748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 W ACADEMY ST",
            "city": "RANDLEMAN",
            "state": "NC",
            "postal_code": "273179748",
            "telephone_number": "336-498-8500",
            "fax_number": "336-498-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "KELLY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "292083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "292083",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP",
            "identifier": "5019530",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica N Joyce
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• Kid Strides Therapy, LLC
• Catherine Liebrand, RD
• Kathryn Needham Lopienski, OT
• Debra Lynn Lund, MA,CAGS ,LMHC, LCMHC
• Rajan Mitchell, D.O.
• National Vision, Inc.
• Jason Lee Newman, D.C.
• North Carolina CVS Pharmacy LLC (CVS Pharmacy #07572)

• Family Nurse Practitioner in Randleman, NC
• Providers in Randleman, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.