Michelle A Lueck, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PAC0150 Issued in ND

Practice address

201 4TH Ave
Enderlin, ND 58027-1325

Phone

(701) 437-3320

Fax

(701) 437-3323

NPI assigned

Jul 17, 2006

Last updated

Mar 4, 2022By the provider in NPPES

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sanford Medical Center Fargo

  dba Sanford 1717 Medical Building

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924
  NPD

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1366469033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 4TH AVE",
            "city": "ENDERLIN",
            "state": "ND",
            "postal_code": "580271325",
            "telephone_number": "701-437-3320",
            "fax_number": "701-437-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 4TH AVE",
            "city": "ENDERLIN",
            "state": "ND",
            "postal_code": "580271325",
            "telephone_number": "701-437-3320",
            "fax_number": "701-437-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUECK",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ND",
            "license": "PAC0150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71086",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012890200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Chiropractic & Massage PC
• Nichole Lynn Francis
• Anna Paige Fuka, PA-C
• Stephanie Keathley
• Debra Lindemann
• Amy Madsen
• Mobilityplus Rehabilitation, LTD
• Margaret E Peterson, D.C.
• Sanford Medical Center Fargo (Sanford Health Enderlin Clinic)
• Corinna Schultz-Marrujo

• Medical Physician Assistant in Enderlin, ND
• Providers in Enderlin, ND by specialty
• Medical Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.