Active NPI
Kelly Kathleen Lucas III, D.C.
- Chiropractor
- Orange, CA
National Provider Identifier
1346328309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC24971
- Practice address
- 1500 E Katella Ave Ste G
Orange, CA 92867-5093 - Phone
- (714) 639-7654
- Fax
- (714) 639-8578
- NPI assigned
- Nov 1, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC24971 | CA | Primary |
Addresses
Primary practice location
1500 E Katella Ave Ste G
Orange, CA 92867-5093
Mailing address
1636 N Gymkhana St
Orange, CA 92869-1032
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040323001841 | CA | Practitioner - Chiropractic | 7719878230 | Practice locations: Orange, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24971 | CA | MD | Marriage & Family Therapist |
| DC24971 | CA | MD | Chiropractor |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346328309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1636 N GYMKHANA ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928691032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E KATELLA AVE STE G",
"city": "ORANGE",
"state": "CA",
"postal_code": "928675093",
"telephone_number": "714-639-7654",
"fax_number": "714-639-8578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "KELLY",
"middle_name": "KATHLEEN",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC24971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.