Individual provider Active NPI

Candy C Lucas, D.C.

  • Chiropractor
  • Fort Lauderdale, FL
National Provider Identifier
1306149992
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10147 Issued in FL
Practice address
4200 SW 54TH CT
Fort Lauderdale, FL 33314
Phone
(954) 999-3661
NPI assigned
Dec 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH10147 FL Primary

Addresses

Primary practice location

4200 SW 54TH CT
Fort Lauderdale, FL 33314

Mailing address

11571 NW 20TH CT
Plantation, FL 33323-2007

Other practice location 1

12565 Orange Dr
Suite 404
Davie, FL 33330-4303
Phone (954) 423-8909

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH10147FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Wellness Group, LLC Chiropractor CurrentSince Nov 3, 2019 Accepting new patients
American Institute of Sport and Function Chiropractor Past Accepting new patients

Locations

4200 SW 54th Ct
Ft Lauderdale, FL 33314
Phone (754) 312-5500

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": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1306149992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11571 NW 20TH CT",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333232007",
            "fax_number": "954-252-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SW 54TH CT",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33314",
            "telephone_number": "954-999-3661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12565 Orange Dr",
            "address_2": "Suite 404",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333304303",
            "country_code": "US",
            "telephone_number": "954-423-8909",
            "fax_number": "954-343-1498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "CANDY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.