Susan Sparks Lukan, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

5007770 Issued in NC

Practice address

1303 Wellstone Circle
Apex, NC 27502

Phone

(510) 427-8464

NPI assigned

Jul 27, 2010

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 names 1

• Ms. Susan Sparks Cassidy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445558400000",
    "number": "1316251853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ROOM 003001 ORANGE ZONE, DUKE SOUTH SB",
            "address_2": "DUKE UNIVERSITY HOSPITAL, DEPT. ADVANCED CLIN. PRACTICE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27710",
            "telephone_number": "510-427-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 WELLSTONE CIRCLE",
            "city": "APEX",
            "state": "NC",
            "postal_code": "27502",
            "telephone_number": "510-427-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKAN",
        "first_name": "SUSAN",
        "middle_name": "SPARKS",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2015-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5007770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "CASSIDY",
            "middle_name": "SPARKS",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Acute Care Nurse Practitioner in Apex, NC
• Providers in Apex, NC by specialty
• Acute Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; 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.