Subricca Nicole Redding Luster, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN261329 Issued in GA

Practice address

1948 Old Ocilla Rd
Tifton, GA 31794-1644

Phone

(229) 391-3500

NPI assigned

Mar 18, 2024

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

Medicare fee-for-service enrollment

Enrolled in GA

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: subricca.luster@phoebehealth.gadirect.net
• Direct secure messaging: subricca.luster.1@8478.direct.athenahealth.com

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.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment Care Compare group NPD
• United Obstetrics and Gynecology, P.C.

  • Obstetrics & Gynecology Physician
  • Tifton, GA
  • NPI 1205847639
  NPD (past)
• Womens Center for Advanced Surgery Inc

  • Ambulatory Surgical Clinic/Center
  • Tifton, GA
  • NPI 1295086049
  NPD (past)

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1598524886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1948 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941644",
            "telephone_number": "229-391-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1948 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941644",
            "telephone_number": "229-391-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Oakland Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "GA",
            "postal_code": "317637200",
            "country_code": "US",
            "telephone_number": "229-391-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDING LUSTER",
        "first_name": "SUBRICCA",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN261329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vikram Ravoory
• Alpa H Ray, M.D.
• Raymond Aldridge MD PC
• Kristy L Redlinger, PAC
• Kyle Register
• Rehabilitation Center of South Georgia, LLC
• Rehabilitation Services of Tifton, Inc.
• Nathan Revels

• Family Nurse Practitioner in Tifton, GA
• Providers in Tifton, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.