Ashley Y Luckett, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Benson, NC
NPI 1639854292 · NPPES record last updated Jun 20, 2023
Key facts
- NPI
- 1639854292
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5018291 (NC)
- Practice address
- 3333 NC Hwy 242 North
Benson, NC 27504-7844 - Phone
- (919) 894-2011
- Fax
- (919) 894-7645
- NPI assigned
- Jun 20, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240208001989 | NC | Practitioner - Nurse Practitioner | 4981066123 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5018291 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Quickcare Family Practice, PLLC | Current |
Accepting new patients | |
| Benson Area Medical Center, Inc. | Current |
Accepting new patients |
Locations
3333 NC Highway 242 N
Benson, NC 27504
Phone (910) 894-2011
2265 NC Highway 24 27 E
Biscoe, NC 27209
Phone (919) 810-0054
4612 Main St
Shallotte, NC 28470
Phone (910) 444-2970
3734 Reynolda Rd
Winston Salem, NC 27106
Phone (336) 601-9720
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5018291 | NC | Yes |
Addresses
Primary practice location
3333 NC Hwy 242 North
Benson, NC 27504-7844
Mailing address
175 Raptor Dr
Smithfield, NC 27577-6511
Phone (919) 274-6080
NPI Registry JSON
{
"created_epoch": "1687219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687219200000",
"number": "1639854292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 RAPTOR DR",
"city": "SMITHFIELD",
"state": "NC",
"postal_code": "275776511",
"telephone_number": "919-274-6080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 NC HWY 242 NORTH",
"city": "BENSON",
"state": "NC",
"postal_code": "275047844",
"telephone_number": "919-894-2011",
"fax_number": "919-894-7645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCKETT",
"first_name": "ASHLEY",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-20",
"last_updated": "2023-06-20",
"certification_date": "2023-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5018291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benson, NC
- Martin Davis Lee
- Liberty Healthcare Group LLC
- Liberty Healthcare Group LLC
- Liberty Healthcare Group LLC
- Christina Lo
- Jodie Ann Lumbrazo
- Michael Lumbrazo
- Stephanie Luna
- Michelle Hyeon Macdonna
- Christopher John Mackinnon
All providers in Benson, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.