Individual provider Active NPI

Nam-Phuong T. Lu, D.O.

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1356374946
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS8549 Issued in FL
Practice address
6484 Fort Caroline Rd
Jacksonville, FL 32277-2042
Phone
(904) 744-7300
Fax
(904) 722-4271
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS8549 FL Primary

Addresses

Primary practice location

6484 Fort Caroline Rd
Jacksonville, FL 32277-2042

Mailing address

619 S Marion Ave
Lake City, FL 32025-5808
Phone (352) 376-1611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090325000312 FL Practitioner - Internal Medicine 7719044429 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS8549FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phuong Lu DO PA Internal Medicine CurrentSince Feb 1, 2009 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
Kindred Hospitals East, LLC CurrentSince Jan 28, 2013 Accepting new patients
Black Bag Medical Inc CurrentSince Jan 28, 2013 Accepting new patients
Oceanview Medicine, PLLC PastSince Nov 1, 2016 Accepting new patients
Hospitalists PRN LLC Internal Medicine Past Accepting new patients
Jacksonville Critical Care Associates PA Internal Medicine Past Accepting new patients

Locations

6817 Southpoint Pkwy
Ste 102
Jacksonville, FL 32216
Phone (904) 513-3998

3720 Beach Blvd
Jacksonville, FL 32207
Phone (904) 399-1623

3840 Belfort Rd
Ste 102
Jacksonville, FL 32216
Phone (904) 371-4051

4320 Deerwood Lake Pkwy
Jacksonville, FL 32216
Phone (904) 620-0599

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Organizations & group practices 8

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1356374946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "352-376-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6484 FORT CAROLINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772042",
            "telephone_number": "904-744-7300",
            "fax_number": "904-722-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "NAM-PHUONG",
        "middle_name": "T.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS8549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.