NPIMap

Individual provider Active NPI

Jonathan Lucas, DNP, FNP-BC

  • Family Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1396129441
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
75558 Issued in WV
Practice address
3200 Maccorkle Ave SE FL 5
Charleston, WV 25304-1227
Phone
(304) 388-4600
Fax
(304) 388-4603
NPI assigned
Jul 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 75558 WV Primary

Addresses

Primary practice location

3200 Maccorkle Ave SE FL 5
Charleston, WV 25304-1227

Mailing address

3200 Maccorkle Ave SE FL 5
Charleston, WV 25304-1227
Phone (304) 388-4600

Other identifiers 1

IdentifierTypeStateIssuer
3810030131MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150928002721 WV Practitioner - Nurse Practitioner 4284942095 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charleston Area Medical Center IncGroup PAC ID 3375441637, 969 clinicians

Practice addresses (Care Compare)

400 Association Dr
Suite 102
Charleston, WV 25311-1298

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Hospital & facility affiliations

  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
75558WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia Health Right, Inc. CurrentSince Jun 24, 2021 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince May 6, 2018 Accepting new patients
Charleston Area Medical Center Inc CurrentSince May 6, 2018 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

3100 Maccorkle Ave SE
Ste 205
Charleston, WV 25304
Phone (304) 388-2303

400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

1520 Washington St E
Charleston, WV 25311
Phone (304) 343-7000

3200 Maccorkle Ave SE
Fl 5
Charleston, WV 25304
Phone (304) 388-1000

3200 Maccorkle Ave SE
#C
Charleston, WV 25304
Phone (304) 347-1336

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12396/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1396129441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE FL 5",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-4600",
            "fax_number": "304-388-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE FL 5",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-4600",
            "fax_number": "304-388-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-17",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "75558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810030131",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.