Individual provider Active NPI

Tara Lucas, A.P.N.

  • Nurse Practitioner
  • Galesburg, IL
National Provider Identifier
1427366376
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209008416 Issued in IL
Practice address
834 N Seminary St
Suite 502
Galesburg, IL 61401-2852
Phone
(309) 343-2262
Fax
(309) 343-2081
NPI assigned
Sep 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209008416 IL Primary
Family Nurse Practitioner 363LF0000X 041278068 IL

Addresses

Primary practice location

834 N Seminary St
Suite 502
Galesburg, IL 61401-2852

Mailing address

834 N Seminary St
Suite 502
Galesburg, IL 61401-2852
Phone (309) 343-2262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110221000084 IL Practitioner - Nurse Practitioner 2961683271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

2560 24TH St
Suite 102
Rock Island, IL 61201-5389
Phone (309) 779-3670

Hospital & facility affiliations

  • Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
  • Hammond Henry Hospital Hospital, Geneseo, IL, CCN 141319
  • Trinity Muscatine Hospital, Muscatine, IA, CCN 160013
  • Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104
  • Genesis Medical Center, Aledo Hospital, Aledo, IL, CCN 141304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041278068ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation CurrentSince Jul 23, 2018 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

600 N College Ave
Ste 120
Geneseo, IL 61254
Phone (309) 944-5342

600 John Deere Rd
Ste 308
Moline, IL 61265
Phone (309) 779-4550

2560 24th St
Ste 102
Rock Island, IL 61201
Phone (309) 779-3670

Interoperability endpoints

  • Direct secure messaging: tlucas635461@direct.unitypoint.org

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1427366376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 N SEMINARY ST",
            "address_2": "SUITE 502",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012852",
            "telephone_number": "309-343-2262",
            "fax_number": "309-343-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 N SEMINARY ST",
            "address_2": "SUITE 502",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012852",
            "telephone_number": "309-343-2262",
            "fax_number": "309-343-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "TARA",
        "credential": "A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209008416",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041278068",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

Verify at the official NPI Registry.