Individual provider Active NPI

Bethany D Lucas, M.D.

  • Family Medicine Physician
  • Edgewood, KY
National Provider Identifier
1477792489
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R1303 Issued in KY
Practice address
413 S Loop Rd
Edgewood, KY 41017-5446
Phone
(859) 301-3800
Fax
(859) 301-3987
NPI assigned
Feb 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 R1303 KY Primary

Addresses

Primary practice location

413 S Loop Rd
Edgewood, KY 41017-5446

Mailing address

413 S Loop Rd
Edgewood, KY 41017-5446
Phone (859) 301-3800

Other identifiers 1

IdentifierTypeStateIssuer
R1303OtherKYSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101007001217 KY Practitioner - Family PracticePractitioner - Hospitalist 5395937429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.83 of 100Reported as group
Quality
78.11
Improvement activities
40
Cost
74.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1303KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine Center, PLLC Family Medicine CurrentSince Sep 17, 2024 Accepting new patients

Locations

1101 Saint Christopher Dr
Ste 250
Ashland, KY 41101
Phone (606) 836-3196

1000 Saint Christopher Dr
Ashland, KY 41101
Phone (606) 833-2273

1180 Saint Christopher Dr
Ashland, KY 41101
Phone (606) 408-3143

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1477792489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175446",
            "telephone_number": "859-301-3800",
            "fax_number": "859-301-3987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175446",
            "telephone_number": "859-301-3800",
            "fax_number": "859-301-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "BETHANY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "R1303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "R1303",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.