Antonette Lucas, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R860519 Issued in MS

Practice address

136 E Ash St
Jackson, MS 39202-2217

Phone

(601) 352-6507

NPI assigned

Mar 23, 2006

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ab Lucas M D PLLC

  • Orthopaedic Hand Surgery Physician
  • Flowood, MS
  • NPI 1457230344
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

• Ms. Antonette Sorrell Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 26, 2010.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269561600000",
    "number": "1699735803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E ASH ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022217",
            "telephone_number": "601-352-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "ANTONETTE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2010-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R860519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RURAL HEALTH",
            "identifier": "253418",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04535731",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTONETTE",
            "last_name": "SORRELL",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brady K Lowery, FNP-C, CEN
• Sydney Kees Lowman
• Penni Pierce Lowrey, CNNP
• Michelle Andrea Lowrie, MS, CCC-SLP
• Elizabeth Lowry, M.S., BCBA, LBA
• Eric Darnell Lucas Jr.
• Kathryn Marsha Annette Lucas, MD
• Matthew Daniel Lucas, MD
• Ryshine Lucas
• Arletta S Luckett-Austin

• All providers in Jackson, MS
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; 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.