Active NPI
Carolyn Lucas
- Physical Therapist
- Eagle River, AK
National Provider Identifier
1447802384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT027712
- Practice address
- 12551 Old Glenn Hwy Ste E
Eagle River, AK 99577-7590 - Phone
- (907) 694-5515
- Fax
- (907) 694-5575
- NPI assigned
- Jul 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT027712 | PA | Primary |
Addresses
Primary practice location
12551 Old Glenn Hwy Ste E
Eagle River, AK 99577-7590
Mailing address
12551 Old Glenn Hwy Ste E
Eagle River, AK 99577-7590
Phone (907) 694-5515
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT027712 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676332800000",
"number": "1447802384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12551 OLD GLENN HWY STE E",
"city": "EAGLE RIVER",
"state": "AK",
"postal_code": "995777590",
"telephone_number": "907-694-5515",
"fax_number": "907-694-5575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12551 OLD GLENN HWY STE E",
"city": "EAGLE RIVER",
"state": "AK",
"postal_code": "995777590",
"telephone_number": "907-694-5515",
"fax_number": "907-694-5575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "CAROLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-11",
"last_updated": "2023-02-14",
"certification_date": "2023-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT027712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle River, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.