Individual provider Active NPI

Jennifer Michelle Lucio, NP

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1952946659
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5012554 Issued in NC
Practice address
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone
(336) 718-8383
Fax
(336) 718-9622
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 5012554 NC
Nurse Practitioner 363L00000X 5012554 NC Primary

Addresses

Primary practice location

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 718-8383

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlucio766885@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200227002541 NC Practitioner - Nurse Practitioner 5496182677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
NH-CL Clinics LLCGroup PAC ID 6305262692, 82 clinicians

Practice addresses (Care Compare)

730 Highland Oaks Dr
Winston Salem, NC 27103-7154
Phone (336) 646-7323

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5012554NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NH-CL Clinics, LLC CurrentSince Jun 2, 2023 Accepting new patients

Locations

500 Pineview Dr
Ste 205
Kernersville, NC 27284
Phone (336) 310-6115

730 Highland Oaks Dr
Winston Salem, NC 27103
Phone (336) 646-7323

Interoperability endpoints

  • Direct secure messaging: jlucio766885@direct.novanthealth.org

Organizations & group practices 1

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": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1952946659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-718-8383",
            "fax_number": "336-718-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-8383",
            "fax_number": "336-718-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIO",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5012554",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlucio766885@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "3333 Silas Creek Pkwy",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.