Individual provider Active NPI

Kenneth Wilson Lucas, MD

  • Family Medicine Physician
  • Richmond, VA
National Provider Identifier
1366417990
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101027078 Issued in VA
Practice address
2205 N Parham Rd
Richmond, VA 23229-3161
Phone
(804) 270-2150
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101027078 VA Primary

Addresses

Primary practice location

2205 N Parham Rd
Richmond, VA 23229-3161

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Other identifiers 1

IdentifierTypeStateIssuer
5630703MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20111206000161 VA Practitioner - Family Practice 3971406695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

601 Potomac Station Dr
Leesburg, VA 20176-1816
Phone (703) 840-1396

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101027078VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Richmond Medical Group PLLC Family Medicine CurrentSince May 13, 1994 Accepting new patients
Patient First Richmond Medical Group PLLC Family Medicine CurrentSince May 13, 1994 Accepting new patients
Patient First Richmond Medical Group PLLC PastSince Sep 26, 2011 Accepting new patients
Patient First Maryland Medical Group PLLC Family Medicine PastSince Feb 28, 2017 Accepting new patients
Patient First Pennsylvania Medical Group PLLC Family Medicine PastSince Jun 2, 2011 Accepting new patients
Patients First Maryland Physicians Group P C Family Medicine PastSince Jan 1, 2015 Accepting new patients

Locations

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

5000 Cox Rd
Ste 100
Glen Allen, VA 23060
Phone (804) 822-4383

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

2205 N Parham Rd
Richmond, VA 23229
Phone (804) 270-2150

Organizations & group practices 6

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1366417990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700",
            "fax_number": "804-217-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 N PARHAM RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232293161",
            "telephone_number": "804-270-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "KENNETH",
        "middle_name": "WILSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101027078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5630703",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.