Individual provider Active NPI

David Paul Lucido, D.C.

  • Chiropractor
  • Lakeland, FL
National Provider Identifier
1578537528
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6810 Issued in FL
Practice address
1965 E Edgewood Dr
Lakeland, FL 33803-3415
Phone
(863) 683-8006
Fax
(863) 683-8225
NPI assigned
Feb 15, 2006
Last updated
Jun 26, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH6810 FL Primary

Addresses

Primary practice location

1965 E Edgewood Dr
Lakeland, FL 33803-3415

Mailing address

1965 E Edgewood Dr
Lakeland, FL 33803-3415
Phone (863) 284-5870

Other identifiers 1

IdentifierTypeStateIssuer
381505600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031231000079 FL Practitioner - Chiropractic 9638077167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1965 E Edgewood Dr
Lakeland, FL 33803-3415
Phone (863) 683-8006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lucido Chiropractic, P.a. Chiropractor CurrentSince Oct 21, 2005 Accepting new patients

Locations

1965 E Edgewood Dr
Lakeland, FL 33803
Phone (863) 683-8006

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1578537528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 E EDGEWOOD DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033415",
            "telephone_number": "863-284-5870",
            "fax_number": "863-248-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 E EDGEWOOD DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033415",
            "telephone_number": "863-683-8006",
            "fax_number": "863-683-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIDO",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381505600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.