Individual provider Active NPI

William Stephen Luking, M.D.

  • Family Medicine Physician
  • Reidsville, NC
National Provider Identifier
1629073176
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38650 Issued in NC
Practice address
520 Maple Ave
Ste B
Reidsville, NC 27320-4600
Phone
(336) 634-3960
Fax
(336) 634-3919
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38650 NC Primary

Addresses

Primary practice location

520 Maple Ave
Ste B
Reidsville, NC 27320-4600

Mailing address

520 Maple Ave
Ste B
Reidsville, NC 27320-4600
Phone (336) 634-3960

Other identifiers 1

IdentifierTypeStateIssuer
8953171MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110913000930 NC Practitioner - Family Practice 1153501457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1629073176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MAPLE AVE",
            "address_2": "STE B",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273204600",
            "telephone_number": "336-634-3960",
            "fax_number": "336-634-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MAPLE AVE",
            "address_2": "STE B",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273204600",
            "telephone_number": "336-634-3960",
            "fax_number": "336-634-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKING",
        "first_name": "WILLIAM",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "38650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8953171",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

Verify at the official NPI Registry.