Organization Active NPI

Lucas Exceptional Healthcare and Consultation PLLC

  • Primary Care Clinic/Center
  • Greensboro, NC
National Provider Identifier
1447927595
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LUCAS EXCEPTIONAL HEALTHCARE AND CONSULTATION PLLC
Practice address
2211 W Meadowview Rd Ste 107
Greensboro, NC 27407-3408
Phone
(336) 543-0480
Fax
(336) 313-2417
NPI assigned
Aug 26, 2021
Last updated
Oct 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Latoya Lucas, APRNNPI 1750696274
Title
Ceo
Phone
(336) 543-0480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary
Adult Health Nurse Practitioner 363LA2200X NU

Addresses

Primary practice location

2211 W Meadowview Rd Ste 107
Greensboro, NC 27407-3408

Mailing address

2211 W Meadowview Rd Ste 107
Greensboro, NC 27407-3408
Phone (336) 543-0480

Other identifiers 2

IdentifierTypeStateIssuer
5004800OtherNCMEDICAL LICENSE
1447927595MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@lucasehc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220614001625 NC Part B Supplier - Clinic/Group Practice 8325427875 Receives reassigned benefits from 1 practitioner
Practice locations: High Point, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2235509Lucas Exceptional Healthcare and2211 W. Meadowview Rd. Suite 107, Greensboro, NC 27407Certificate of waiverSep 8, 2027

National Provider Directory

National Provider Directory

Locations

2211 W Meadowview Rd
#1
Greensboro, NC 27407

2211 W Meadowview Rd
Ste 107
Greensboro, NC 27407
Phone (336) 543-0480

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1447927595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 W MEADOWVIEW RD STE 107",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274073408",
            "telephone_number": "336-543-0480",
            "fax_number": "336-313-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 W MEADOWVIEW RD STE 107",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274073408",
            "telephone_number": "336-543-0480",
            "fax_number": "336-313-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCAS EXCEPTIONAL HEALTHCARE AND CONSULTATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-26",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "LATOYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-543-0480",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "5004800",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447927595",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@lucasehc.com",
            "affiliation": "N",
            "address_1": "2211 W Meadowview Rd Ste 107",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274073408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.