Individual provider Active NPI

Lucy Duckworth

  • Registered Nurse
  • Fort Myer, VA
National Provider Identifier
1457789208
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0001184034 Issued in VA
Practice address
401 Carpenter Rd
Fort Myer, VA 22211-1009
Phone
(703) 696-2977
Fax
(703) 696-0103
NPI assigned
Oct 14, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001184034 VA Primary

Addresses

Primary practice location

401 Carpenter Rd
Fort Myer, VA 22211-1009

Mailing address

401 Carpenter Rd
Fort Myer, VA 22211-1009
Phone (703) 696-2977

Other identifiers 1

IdentifierTypeStateIssuer
VAD000OtherVAUPIN

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

State licenses

LicenseStateTypeSpecialty
0001184034VAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381708800000",
    "number": "1457789208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CARPENTER RD",
            "city": "FORT MYER",
            "state": "VA",
            "postal_code": "222111009",
            "telephone_number": "703-696-2977",
            "fax_number": "703-696-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CARPENTER RD",
            "city": "FORT MYER",
            "state": "VA",
            "postal_code": "222111009",
            "telephone_number": "703-696-2977",
            "fax_number": "703-696-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "LUCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-14",
        "last_updated": "2013-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001184034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "VAD000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myer, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; 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.