Luckycharm Primary Care PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LUCKYCHARM PRIMARY CARE PLLC

Practice address

3521 N Fourth Street, Suite 100
Longview, TX 75605

Phone

(903) 448-2273

Fax

(773) 825-8352

NPI assigned

Apr 21, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Uchenne Evans Mbaraonye, DONPI 1629633235

Title

Owner

Phone

(937) 554-8570

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Uchenne Evans Mbaraonye, DO

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1629633235
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766966400000",
    "number": "1336935857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 GILMER RD STE 101",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042133",
            "telephone_number": "903-488-2273",
            "fax_number": "773-825-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 N FOURTH STREET, SUITE 100",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75605",
            "telephone_number": "903-448-2273",
            "fax_number": "773-825-8352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N High St Ste 21",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015105",
            "country_code": "US",
            "telephone_number": "903-488-2273",
            "fax_number": "773-825-8352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUCKYCHARM PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A",
        "authorized_official_last_name": "MBARAONYE",
        "authorized_official_first_name": "UCHENNE",
        "authorized_official_middle_name": "EVANS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-554-8570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James David Lowe, M.D.
• Amber Nicole Lowery, NP-C
• Cynthia Denise Berry Lowery, LPC
• Miriam Segura Lowery, PMHNP-BC
• Sean Lowery, AUD
• Stephen F Lummus, PA-C
• Julie Lundy, M.D.
• Luz Angelica Guevara
• Phuong Kim Ly, MD
• Kyle Fitzgerald Lybarger, MPT

• Internal Medicine Physician in Longview, TX
• Providers in Longview, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.