Individual provider Active NPI

Cory Allen Luckie, MD

  • Family Medicine Physician
  • Prattville, AL
National Provider Identifier
1457708166
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36124 Issued in AL
Practice address
645 McQueen Smith Rd N Ste 309
Prattville, AL 36066-7269
Phone
(334) 568-4500
Fax
(334) 568-4501
NPI assigned
May 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36124 AL Primary

Addresses

Primary practice location

645 McQueen Smith Rd N Ste 309
Prattville, AL 36066-7269

Mailing address

301 Brown Springs Rd
Montgomery, AL 36117-7005
Phone (334) 747-4159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180927003316 AL Practitioner - Family PracticePractitioner - Internal MedicinePractitioner - Emergency Medicine 5890071914 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Alabama School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

645 McQueen Smith Rd N
Suite 309
Prattville, AL 36066-7269
Phone (334) 568-4750

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Prattville, AL, CCN 017055
  • Enhabit Home Health Home health agency, Troy, AL, CCN 017324
  • Amedisys Home Health of Montgomery Home health agency, Montgomery, AL, CCN 017319
  • Prattville Baptist Hospital Hospital, Prattville, AL, CCN 010108
  • Baptist Medical Center South Hospital, Montgomery, AL, CCN 010023

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36124ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Ivy Creek Specialty Care CurrentSince Dec 1, 2020 Accepting new patients
Ivy Creek of Elmore, LLC Family Medicine CurrentSince May 28, 2020 Accepting new patients
Ivy Creek of Elmore, LLC Current Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Aug 1, 2023 Accepting new patients
Ivy Creek of Elmore LLC CurrentSince May 28, 2020 Accepting new patients
Physical Express Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Ivy Creek of Elmore, LLC Current Accepting new patients
Ivy Creek Specialty Care CurrentSince Dec 1, 2020 Accepting new patients
The Health Care Authority for Baptist Health an Affiliate of Uabhs Past Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Family Medicine Past Accepting new patients

Locations

4412 Hogan Rd
Deatsville, AL 36022
Phone (334) 514-4851

4081 Highway 14
Millbrook, AL 36054
Phone (334) 285-3222

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

645 McQueen Smith Rd N
Ste 309
Prattville, AL 36066
Phone (334) 358-2010

41 Cambridge Ct
Wetumpka, AL 36093
Phone (334) 567-3309

525 Hospital Dr
Ste B
Wetumpka, AL 36092
Phone (334) 567-5626

500 Hospital Dr
Wetumpka, AL 36092
Phone (334) 283-2542

Organizations & group practices 11

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": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1457708166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BROWN SPRINGS RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177005",
            "telephone_number": "334-747-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 MCQUEEN SMITH RD N STE 309",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667269",
            "telephone_number": "334-568-4500",
            "fax_number": "334-568-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKIE",
        "first_name": "CORY",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-23",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "36124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

Verify at the official NPI Registry.