Delores A Lucky, C-FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

44396 Issued in WV

Practice address

818 Arbuckle Road
Suite 102
Summersville, WV 26651-1086

Phone

(304) 883-2310

Fax

(304) 883-2312

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Summersville Skin Care Center Inc

  • Nurse Practitioner
  • Summersville, WV
  • NPI 1346316395
  Medicare reassignment NPD Authorized official
• West Virginia Em-I Medical Services

  • Emergency Medicine Physician
  • Summersville, WV
  • NPI 1598148553

  Nurse Practitioner

  NPD (past)
• Dermatology Centers Inc

  • Dermatology Physician
  • Low Moor, VA
  • NPI 1922456409
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271116800000",
    "number": "1528174331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 ARBUCKLE ROAD",
            "address_2": "SUITE 102",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511086",
            "telephone_number": "304-883-2310",
            "fax_number": "304-883-2312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 ARBUCKLE ROAD",
            "address_2": "SUITE 102",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511086",
            "telephone_number": "304-883-2310",
            "fax_number": "304-883-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKY",
        "first_name": "DELORES",
        "middle_name": "A",
        "credential": "C-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2010-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "44396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7102018000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Long Point Emergency Physicians LLC
• Kayla Long
• Kenneth Pierre Mascarinas Lopez, PT, DPT
• Briana Danielle Loudin-Hughart
• Cynthia Louise Lough
• Grace Kathryn Lucky, DDS
• Kameron Charles Lucky, DDS
• Kevin Charles Lucky, DDS
• Angela Malcomb, RN
• Amy Mann

• Nurse Practitioner in Summersville, WV
• Providers in Summersville, WV by specialty
• Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.