Fort Davis Family Practice, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FORT DAVIS FAMILY PRACTICE, PA

Practice address

1 Memorial Square
Box 792
Fort Davis, TX 79734-0008

Phone

(432) 426-3217

Fax

(432) 426-3084

NPI assigned

Aug 30, 2007

Last updated

Apr 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James D Luecke, MDNPI 1184692881

Title

Owner/Physician

Phone

(432) 426-3217

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIJFBD

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Luecke, MD

  • Family Medicine Physician
  • Fort Davis, TX
  • NPI 1184692881
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1578757720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 792",
            "address_2": "1 MEMORIAL SQUARE",
            "city": "FORT DAVIS",
            "state": "TX",
            "postal_code": "797340008",
            "telephone_number": "432-426-3217",
            "fax_number": "432-426-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL SQUARE",
            "address_2": "BOX 792",
            "city": "FORT DAVIS",
            "state": "TX",
            "postal_code": "797340008",
            "telephone_number": "432-426-3217",
            "fax_number": "432-426-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT DAVIS FAMILY PRACTICE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "LUECKE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "432-426-3217",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144621303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• County of Jeff Davis
• Fort Davis Independent School District
• Thomas John Homrighaus, LPC
• James Luecke, MD
• Silvanna Lynn Ramos Milan, LMSW
• Jerry Don Mitchell, ED.D., PSYCHOLOGIST

• Family Medicine Physician in Fort Davis, TX
• Providers in Fort Davis, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.