Individual provider Active NPI

Gary Allen Luken, MD

  • Family Medicine Physician
  • Savannah, GA
National Provider Identifier
1760499412
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36964 Issued in AZ
Practice address
325 West Montgomery Cross Road
Savannah, GA 31406-5641
Phone
(208) 989-0813
NPI assigned
Aug 2, 2006
Last updated
Jan 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36964 AZ Primary

Addresses

Primary practice location

325 West Montgomery Cross Road
Savannah, GA 31406-5641

Mailing address

325 W Montgomery Cross Rd
Savannah, GA 31406-3309
Phone (888) 878-6886

Other identifiers 2

IdentifierTypeStateIssuer
020537MedicaidAZ
AZ0201750OtherAZAZ BLUECROSS AND BLUESHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140520001459 GA Practitioner - Family PracticePractitioner - Emergency Medicine 7810088531 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Emergency Group, LLC CurrentSince Mar 15, 2014 Accepting new patients
Gary a Luken MD Family Medicine PastSince Jan 1, 1990 Accepting new patients
Emcare Physician Providers, Inc Past Accepting new patients

Locations

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

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.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1760499412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W MONTGOMERY CROSS RD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063309",
            "telephone_number": "888-878-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 WEST MONTGOMERY CROSS ROAD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314065641",
            "telephone_number": "208-989-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKEN",
        "first_name": "GARY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "36964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020537",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ BLUECROSS AND BLUESHIELD",
            "identifier": "AZ0201750",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.