Individual provider Active NPI

Ala Bianca Naomi Lucky, NP

  • Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1902391469
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
21969 Issued in SC
Practice address
1718 Saint Julian PL
Columbia, SC 29204-2410
Phone
(803) 708-8392
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 21969 SC Primary

Addresses

Primary practice location

1718 Saint Julian PL
Columbia, SC 29204-2410

Mailing address

753 S Sage Drop Rd
Blythewood, SC 29016-9265
Phone (803) 200-3748

Other identifiers 1

IdentifierTypeStateIssuer
NP5843MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Aug 1, 2021 Accepting new patients
Musc Community Physicians CurrentSince Aug 1, 2021 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

2001 Laurel St
Fl 2
Columbia, SC 29204
Phone (803) 254-3278

Organizations & group practices 3

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1902391469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 S SAGE DROP RD",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290169265",
            "telephone_number": "803-200-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 SAINT JULIAN PL",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042410",
            "telephone_number": "803-708-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKY",
        "first_name": "ALA",
        "middle_name": "BIANCA NAOMI",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "21969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP5843",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.