Rebecca L Lucas, DNP
Individual provider Active NPI Family Nurse Practitioner · Ennis, TX
NPI 1487811097 · NPPES record last updated Oct 25, 2019
Key facts
- NPI
- 1487811097
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 110709 (TX)
- Practice address
- 2203 W Lampasas St
Ennis, TX 75119-5666 - Phone
- (972) 875-8833
- Fax
- (972) 875-8866
- NPI assigned
- May 21, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Vip Healthcare PLLC
Practice addresses (Care Compare)
601 S Clay St
Suite 104
Ennis, TX 75119-5771
Phone (978) 875-6600
Hospital & facility affiliations
- Angels Care Home Health
- Ennis Regional Medical Center
- Baylor Scott & White Medical Center- Waxahachie
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120106000470 | TX | Practitioner - Nurse Practitioner | 6608042015 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110709 | TX | MD | Speech-Language Pathologist |
| 517664 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vip Healthcare, PLLC | Current |
Accepting new patients |
Locations
601 S Clay St
Ste 104
Ennis, TX 75119
Phone (972) 875-6600
Interoperability endpoints
- nef8783@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 110709 | TX | Yes |
| Family Nurse Practitioner | 363LF0000X | 517664 | TX |
Addresses
Primary practice location
2203 W Lampasas St
Ennis, TX 75119-5666
Mailing address
2203 W Lampasas St Ste 210
Ennis, TX 75119-5668
Phone (972) 875-8833
NPI Registry JSON
{
"created_epoch": "1211328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571961600000",
"number": "1487811097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2203 W LAMPASAS ST STE 210",
"city": "ENNIS",
"state": "TX",
"postal_code": "751195668",
"telephone_number": "972-875-8833",
"fax_number": "987-875-8866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2203 W LAMPASAS ST",
"city": "ENNIS",
"state": "TX",
"postal_code": "751195666",
"telephone_number": "972-875-8833",
"fax_number": "972-875-8866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "REBECCA",
"middle_name": "L",
"credential": "DNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-21",
"last_updated": "2019-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "110709",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "517664",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ennis, TX
- Liberty Therapy, P.a.
- Living Single LLC
- Vernesha D Lockhart
- Sebastian Alfredo Lopez
- Shayna Arnette Lowe
- Linda Carol Mach
- Jesus Marcial
- Mallory L Martin
- Ariana Estela Martinez
- Natasha Mazaheri
All providers in Ennis, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.