NPIMap

Individual provider Active NPI

John Albert Lucas IV, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Greer, SC
National Provider Identifier
1659692952
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
36938 Issued in SC
Practice address
2755 S Highway 14
Suite 1200L
Greer, SC 29650-4902
Phone
(864) 849-9150
Fax
(864) 849-9334
NPI assigned
Jun 21, 2010
Last updated
Feb 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 36938 SC
Family Medicine Physician 207Q00000X TL36938 SC
Sports Medicine (Family Medicine) Physician 207QS0010X 36938 SC Primary

Addresses

Primary practice location

2755 S Highway 14
Suite 1200L
Greer, SC 29650-4902

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other identifiers 6

IdentifierTypeStateIssuer
SC3619J577OtherSCMEDICARE PIN
369381MedicaidSC
SC36197628OtherSCMEDICARE PIN
SC36196121OtherSCMEDICARE PIN
SC36196084OtherSCMEDICARE PIN
SC36196067OtherSCMEDICARE PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlucas9222@direct-srhs.et0939.epichosted.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140827002004 SC Practitioner - Sports MedicinePractitioner - Family Practice 7618195959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
University of Alabama School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

100 E Wood St
Spartanburg, SC 29303-3004
Phone (864) 560-7070

9768 Warren H Abernathy Hwy
B
Spartanburg, SC 29301-5201
Phone (864) 560-2663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL36938SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Jun 9, 2014 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

2755 S Highway 14
Ste 1200L
Greer, SC 29650
Phone (864) 849-9144

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1659692952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 S HIGHWAY 14",
            "address_2": "SUITE 1200L",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296504902",
            "telephone_number": "864-849-9150",
            "fax_number": "864-849-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "JOHN",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-21",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "36938",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "TL36938",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "SC",
            "license": "36938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC3619J577",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369381",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC36197628",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC36196121",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC36196084",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC36196067",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlucas9222@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jlucas9222@direct-srhs.et0939.epichosted.com",
            "address_1": "2755 S Highway 14",
            "address_2": "Suite 1200L",
            "city": "Greer",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296504902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.