Active NPI
Rachel Crea Lucas, D.O.
- Pediatrics Physician
- New Berlin, WI
National Provider Identifier
1679816813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 63288-21
- Practice address
- 4855 N. Moorland Road
Urgent Care Clinic
New Berlin, WI 53151-7494 - Phone
- (262) 432-7599
- Fax
- (262) 432-7694
- NPI assigned
- Apr 5, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Hospice and Palliative Medicine Physician | 2080H0002X | 05259 | KY | |
| Pediatrics Physician | 208000000X | 63288-21 | WI | Primary |
Addresses
Primary practice location
4855 N. Moorland Road
Urgent Care Clinic
New Berlin, WI 53151-7494
Mailing address
300 Cassidy Ave
Lexington, KY 40502-2503
Phone (952) 412-5669
Other practice location 1
800 Rose St Fl 4
Lexington, KY 40536-3026
Phone (859) 218-2581
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679816813 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63288-21 | WI | MD | Pediatrics Physician |
Interoperability endpoints
- rlucas110420@direct.chw.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681344000000",
"number": "1679816813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 CASSIDY AVE",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405022503",
"telephone_number": "952-412-5669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 N. MOORLAND ROAD",
"address_2": "URGENT CARE CLINIC",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531517494",
"telephone_number": "262-432-7599",
"fax_number": "262-432-7694"
}
],
"practiceLocations": [
{
"address_1": "800 Rose St Fl 4",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "KY",
"postal_code": "405363026",
"country_code": "US",
"telephone_number": "859-218-2581",
"fax_number": "859-257-1632",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUCAS",
"first_name": "RACHEL",
"middle_name": "CREA",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-05",
"last_updated": "2023-04-13",
"certification_date": "2023-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "2080H0002X",
"taxonomy_group": "",
"desc": "Pediatrics, Hospice and Palliative Medicine",
"state": "KY",
"license": "05259",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "63288-21",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1679816813",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Berlin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.