Organization Active NPI

Douglas K Luke MD Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Roseville, CA
National Provider Identifier
1679600779
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
G16645 Issued in CA
Legal business name
DOUGLAS K LUKE MD INC
Practice address
1424 Oak Hill Way
Roseville, CA 95661-4015
Phone
(916) 791-3024
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Authorized official

Name
Douglas K Luke, MD
Title
President
Phone
(916) 791-3024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X G16645 CA Primary

Addresses

Primary practice location

1424 Oak Hill Way
Roseville, CA 95661-4015

Mailing address

1424 Oak Hill Way
Roseville, CA 95661-4015
Phone (916) 791-3024

Other identifiers 1

IdentifierTypeStateIssuer
00G166450MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1679600779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 OAK HILL WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614015",
            "telephone_number": "916-791-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 OAK HILL WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614015",
            "telephone_number": "916-791-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS K LUKE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "LUKE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-791-3024",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "G16645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G166450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; 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.