Nissa Breann Lucero, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

64501484405 Issued in UT

Practice address

415 N Main St
Spanish Fork, UT 84660-1439

Phone

(801) 798-9700

Fax

(801) 798-3131

NPI assigned

Feb 14, 2011

Sex

Female

Sole proprietor

No

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

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Regional Physician Services of Texas, P.a.

  • Nurse Practitioner
  • Abilene, TX
  • NPI 1043529944
  Medicare reassignment

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1811294697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N MAIN ST",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601439",
            "telephone_number": "801-798-9700",
            "fax_number": "801-798-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N MAIN ST",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601439",
            "telephone_number": "801-798-9700",
            "fax_number": "801-798-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCERO",
        "first_name": "NISSA",
        "middle_name": "BREANN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-14",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "64501484405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desmond Cornell Lomax, CMHC
• Katrina Gubler Long, LMT
• Sheila Lor
• Breeana Loveland
• Isabell Lucero
• Serenity Dawn Lucio, TRT
• David E Ludlow, M.D.
• Randy Roy Lundell, D.O.
• Scott Duane Lynde
• Carter S Lytle, M.D.

• Family Nurse Practitioner in Spanish Fork, UT
• Providers in Spanish Fork, 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 Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.