Mary Lyn T Lu, MD, FACS

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

25642 Issued in KY

Practice address

126 Trivette Dr
Suite 201
Pikeville, KY 41501-1275

Phone

(606) 432-0061

Fax

(606) 432-0095

NPI assigned

Oct 12, 2005

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 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Eastern Ky Center for Plastic, Reconstructive & Cosmetic Surgery

  dba Kentucky Center for Plastic Surgery

  • Medical Specialty Clinic/Center
  • Pikeville, KY
  • NPI 1982879888
  NPD (past)

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1407844566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415022257",
            "telephone_number": "606-432-0061",
            "fax_number": "606-432-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 TRIVETTE DR",
            "address_2": "SUITE 201",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011275",
            "telephone_number": "606-432-0061",
            "fax_number": "606-432-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "MARY LYN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD, FACS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "KY",
            "license": "25642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64256423",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV MEDICAID",
            "identifier": "0114191000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE",
            "identifier": "240005992",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000000051790",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1532903",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles E Lowe III, MD
• John Clayton Lowe, DMD
• Larry Mark Lowe, RBT
• Mavis Lowe, APRN
• LP Pikeville LLC (Signature HealthCARE of Pikeville)
• Stacy Lucas
• Wendy Darrnell Lucas, RBT
• Michael D Ludlow, APRN
• Sean Ly, DO
• Angela K Maggard, MD

• Plastic and Reconstructive Surgery Physician in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Plastic and Reconstructive Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.