Individual provider Active NPI

Linda R Luckow, RN

  • Registered Nurse
  • Smithtown, NY
National Provider Identifier
1417288440
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
483884 Issued in NY
Practice address
14 Bellemeade Ave
Smithtown, NY 11787-1857
Phone
(631) 265-5300
NPI assigned
Jan 14, 2010
Last updated
Jan 14, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 483884 NY Primary
Home Health Registered Nurse 163WH0200X 483884 NY

Addresses

Primary practice location

14 Bellemeade Ave
Smithtown, NY 11787-1857

Mailing address

3 Francis St
East Setauket, NY 11733-1813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
483884NYMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Nursing Registry, Inc. Past Accepting new patients
Christian Nursing Registry Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1417288440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 FRANCIS ST",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 BELLEMEADE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871857",
            "telephone_number": "631-265-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKOW",
        "first_name": "LINDA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "483884",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "483884",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.