W.D.Lucky, M.D., Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

0029049 Issued in FL

Legal business name

W.D.LUCKY, M.D., INC

Practice address

13520 SW 152ND St
#771834
Miami, FL 33177-0031

Phone

(305) 238-3990

NPI assigned

Jun 27, 2006

Last updated

Jan 5, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William David Lucky, M.D.NPI 1538168075

Title

President

Phone

(305) 238-3990

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• W.D. Lucky, M.D., Inc Other name

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William David Lucky Sr., MD

  • Specialist
  • Homestead, FL
  • NPI 1538168075
  Authorized official Same address or phone
• Lori Dunn, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Greensboro, GA
  • NPI 1619976578
  NPD (past)
• Donna F. Groover, M.D.

  • Family Medicine Physician
  • Covington, GA
  • NPI 1710923461
  NPD (past)
• Kristi Lynne St Martin, MD

  • Hospitalist Physician
  • Marrero, LA
  • NPI 1477545309
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1396772224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13520 SW 152ND ST",
            "address_2": "#771834",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331770031",
            "telephone_number": "305-238-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13520 SW 152ND ST",
            "address_2": "#771834",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331770031",
            "telephone_number": "305-238-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.D.LUCKY, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "LUCKY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-238-3990",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "0029049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE INDIVIDUAL PTAN",
            "identifier": "95193Y",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038136500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "W.D. Lucky, M.D., Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.