Individual provider Active NPI

Edel Luckey, NP

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1770059263
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP136762 Issued in TX
Practice address
7777 Forest LN
Dallas, TX 75230-2571
Phone
(469) 733-5701
NPI assigned
Oct 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP136762 TX Primary

Addresses

Primary practice location

7777 Forest LN
Dallas, TX 75230-2571

Mailing address

2512 Hidden Springs Dr
Mesquite, TX 75181-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191127000087 TX Practitioner - Nurse Practitioner 1759714058 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP136762TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Texas, PLLC Nurse Practitioner CurrentSince Apr 30, 2020 Accepting new patients
Vpa of Texas PLLC CurrentSince Jul 2, 2020 Accepting new patients
Cogent Healthcare of Texas, PA Nurse Practitioner CurrentSince May 1, 2020 Accepting new patients
Vpa of Texas PLLC CurrentSince Jul 2, 2020 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients

Locations

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Interoperability endpoints

  • Direct secure messaging: ms_eluckey@landmarkhealth-direct.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1770059263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 HIDDEN SPRINGS DR",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751814000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302571",
            "telephone_number": "469-733-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKEY",
        "first_name": "EDEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP136762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.