Lucius Willson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT643 Issued in KY

Practice address

3401 Yorkshire Medical Park
Lexington, KY 40509-2513

Phone

(859) 263-5140

NPI assigned

May 13, 2018

Last updated

May 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61440

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.

• Bluegrass Orthopaedics PSC

  • Durable Medical Equipment & Medical Supplies
  • Lexington, KY
  • NPI 1164922266
  NPD (past)
• Bluegrass Orthopaedics PSC

  dba Bluegrass Orthopaedics

  • Orthopaedic Surgery Physician
  • Lexington, KY
  • NPI 1447622394
  NPD (past)

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

{
    "created_epoch": "1526169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526169600000",
    "number": "1366932659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 BRAMBLEWOOD DR",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407017427",
            "telephone_number": "606-627-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 YORKSHIRE MEDICAL PARK",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092513",
            "telephone_number": "859-263-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "LUCIUS",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-13",
        "last_updated": "2018-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "AT643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Alexander Willoughby, MHS, OTR/L, CHT
• Laura Denise Willoughby, OT
• Willow Creek Counseling Center LLC
• Willow Tree Pediatrics of Lexington
• Jeffrey W Wills, PT
• Theresa Ann Wilp, APRN
• H Andrew Wilsey, PHARMD
• Andrea Taylor Wilson Graf
• Wilson Pediatric Therapy LLC
• Wilson Pediatric Therapy LLC

• Athletic Trainer in Lexington, KY
• Providers in Lexington, KY by specialty
• Athletic Trainer in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2018; 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.