NPIMap

Organization Active NPI

Luca Family Clinic

  • Primary Care Clinic/Center
  • Douglasville, GA
National Provider Identifier
1619214517
Registry record updated Jan 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
054287 Issued in GA
Legal business name
LUCA FAMILY CLINIC
Practice address
2121 Fairburn Rd
Suite B
Douglasville, GA 30135-1007
Phone
(256) 468-5903
NPI assigned
Jan 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2013

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

Authorized official

Name
Mr. Chike C Aniukwu
Title
Manager
Phone
(256) 468-5903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 054287 GA Primary

Addresses

Primary practice location

2121 Fairburn Rd
Suite B
Douglasville, GA 30135-1007

Mailing address

2121 Fairburn Rd
Suite B
Douglasville, GA 30135-1007
Phone (256) 468-5903

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359072000000",
    "number": "1619214517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 FAIRBURN RD",
            "address_2": "SUITE B",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351007",
            "telephone_number": "256-468-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 FAIRBURN RD",
            "address_2": "SUITE B",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351007",
            "telephone_number": "256-468-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCA FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-25",
        "status": "A",
        "authorized_official_last_name": "ANIUKWU",
        "authorized_official_first_name": "CHIKE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "256-468-5903",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "054287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; 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.