Individual provider Active NPI

Kathryn Caroline Hickey Lucas, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1578886776
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-33291 Issued in AZ
Practice address
4215 E Bell Rd BLDG a
Phoenix, AZ 85032-2212
Phone
(602) 933-7529
Fax
(602) 933-4296
NPI assigned
Mar 3, 2010
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05011763A IN
Physical Therapist 225100000X 12754 OH
Physical Therapist 225100000X LPT-33291 AZ Primary

Addresses

Primary practice location

4215 E Bell Rd BLDG a
Phoenix, AZ 85032-2212

Mailing address

2108 E Thomas Rd
Phoenix, AZ 85016-7761
Phone (602) 933-3124

Other practice location 1

3602 Northgate Ct
New Albany, IN 47150-6417
Phone (812) 944-1377

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-33291AZMDPhysical Therapist
12754OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Employment Services, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kathryn.lucas.1@5919.direct.athenahealth.com

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": "1267574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1578886776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167761",
            "telephone_number": "602-933-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 E BELL RD BLDG A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322212",
            "telephone_number": "602-933-7529",
            "fax_number": "602-933-4296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3602 Northgate Ct",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471506417",
            "country_code": "US",
            "telephone_number": "812-944-1377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "KATHRYN",
        "middle_name": "CAROLINE HICKEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-03",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011763A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "12754",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-33291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.