Mitchell Scott Lucas, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2000169523 Issued in MO

Practice address

54 Hospital Dr
Osage Beach, MO 65065-3050

Phone

(573) 964-6010

Fax

(573) 964-6909

NPI assigned

Mar 19, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1821112459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SHERWOOD DR",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650202329",
            "telephone_number": "573-434-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-964-6010",
            "fax_number": "573-964-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "MITCHELL",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2000169523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra K Lonergan, OT
• John M Loney, M.D.
• Louis J Quintero MD
• Erin Lucas, PHARM. D.
• Kelly Fromm Lucas, PTA
• Lisa Marie Luetkemeyer, MHS, CCC-SLP
• Nicholas Lyons, CRNA
• Rebecca Ellen Maasen, MACCC-SLP
• Mario Alejandro Macias II, DO
• Brittaney Maggard, PLPC

• Physical Therapy Assistant in Osage Beach, MO
• Providers in Osage Beach, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.