Active NPI
Jeffery Lucas, PHD/ABD, OTR/L
- Occupational Therapist
- Wilson, NC
National Provider Identifier
1770954067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 9985
- Practice address
- 2501 Downing St SW
Wilson, NC 27893-4517 - Phone
- (252) 237-6300
- NPI assigned
- Oct 13, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 9985 | NC | Primary |
| Occupational Therapist | 225X00000X | 0119006732 | VA |
Addresses
Primary practice location
2501 Downing St SW
Wilson, NC 27893-4517
Mailing address
1101 Caymus Rd Apt 211
Chesapeake, VA 23320-7514
Phone (252) 236-2705
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9985 | NC | MD | Pharmacist |
| 0119006732 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444694400000",
"number": "1770954067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 CAYMUS RD APT 211",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233207514",
"telephone_number": "252-236-2705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 DOWNING ST SW",
"city": "WILSON",
"state": "NC",
"postal_code": "278934517",
"telephone_number": "252-237-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "JEFFERY",
"credential": "PHD/ABD, OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-13",
"last_updated": "2015-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "9985",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119006732",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.