Individual provider Active NPI

Lucianne Cronin, F.N.P.,PH.D.

  • Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1497811079
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
200959 Issued in NC
Practice address
1006 Union Rd Ste D
Gastonia, NC 28054-5591
Phone
(704) 810-0006
Fax
(704) 375-6133
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 200959 NC
Nurse Practitioner 363L00000X 200959 NC Primary

Addresses

Primary practice location

1006 Union Rd Ste D
Gastonia, NC 28054-5591

Mailing address

1645 Nassau Blvd
Charlotte, NC 28205-3564
Phone (704) 375-5298

Other identifiers 3

IdentifierTypeStateIssuer
80567OtherNCN.P.
200959OtherNCR.N.
6005038MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200959NCMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1497811079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 NASSAU BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282053564",
            "telephone_number": "704-375-5298",
            "fax_number": "704-375-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 UNION RD STE D",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545591",
            "telephone_number": "704-810-0006",
            "fax_number": "704-375-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONIN",
        "first_name": "LUCIANNE",
        "name_prefix": "Dr.",
        "credential": "F.N.P.,PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "200959",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "200959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N.P.",
            "identifier": "80567",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.N.",
            "identifier": "200959",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005038",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.