Gina Luckianow

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1060 Issued in AL

Practice address

1940 Elmer J Bissell Rd
Birmingham, AL 35243-2941

Phone

(205) 638-4949

NPI assigned

Jun 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1891922431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 ELMER J BISSELL RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352432941",
            "telephone_number": "205-638-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 ELMER J BISSELL RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352432941",
            "telephone_number": "205-638-4949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Cedar St",
            "address_2": "BB 310",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103218",
            "country_code": "US",
            "telephone_number": "203-785-2572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCKIANOW",
        "first_name": "GINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "001512",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA1060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Griffin Lucas
• Whitney Lucas
• Alyxandra Lucero, M ED
• Kathryn Louise Oliver Luckett, MD
• Tracy Luckhardt
• Hallie Luckianow, M.S., CCC-SLP
• Haley Marie Luckie, MD
• Adam Timothy Lucy, MD
• Donald Steven Jacob Ludden, PHARMD RPH
• Shea Monique Ludgood, CRNP

• Physician Assistant in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.