Individual provider Active NPI

Cynthia D Lucas, RNCWHNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Macon, GA
National Provider Identifier
1881658177
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
R125151 Issued in GA
Practice address
650 Coliseum PL
Macon, GA 31217-3867
Phone
(478) 745-7935
Fax
(478) 745-7806
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X R125151 GA Primary

Addresses

Primary practice location

650 Coliseum PL
Macon, GA 31217-3867

Mailing address

650 Coliseum PL
Macon, GA 31217-3867
Phone (478) 745-7935

Other identifiers 1

IdentifierTypeStateIssuer
00933754AMedicaidGA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101124000592 GA Practitioner - Nurse Practitioner 8123214517 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R125151GAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Macon GYN/OB Associates CurrentSince Oct 1, 1998 Accepting new patients
Macon GYN OB Associates II, LLC Past Accepting new patients

Locations

650 Coliseum Pl
Macon, GA 31217
Phone (478) 745-7935

Organizations & group practices 2

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1881658177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 COLISEUM PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173867",
            "telephone_number": "478-745-7935",
            "fax_number": "478-745-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 COLISEUM PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173867",
            "telephone_number": "478-745-7935",
            "fax_number": "478-745-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "CYNTHIA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "RNCWHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "GA",
            "license": "R125151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00933754A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.