Carolyn M. Luckett, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

220048-4405 Issued in UT

Practice address

2000 Circle of Hope Dr
Clinic 2D
Salt Lake City, UT 84112-5550

Phone

(801) 585-0100

Fax

(801) 581-7381

NPI assigned

Feb 11, 2009

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1710126966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 S 500 E STE 600",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021971",
            "telephone_number": "801-587-6705",
            "fax_number": "801-715-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CIRCLE OF HOPE DR",
            "address_2": "CLINIC 2D",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125550",
            "telephone_number": "801-585-0100",
            "fax_number": "801-581-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKETT",
        "first_name": "CAROLYN",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "220048-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.