Individual provider Active NPI

Tracy Lucas, NP

  • Family Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1972675841
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024174742 Issued in VA
Practice address
401 Gresham Dr
Norfolk, VA 23507
Phone
(576) 688-7000
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024174742 VA Primary
Pediatrics Physician 208000000X F333506 NY

Addresses

Primary practice location

401 Gresham Dr
Norfolk, VA 23507

Mailing address

601 Childrens LN
Norfolk, VA 23507-1910
Phone (757) 668-7007

Other identifiers 1

IdentifierTypeStateIssuer
02762825MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20171003007510 VA Practitioner - Nurse Practitioner 9335321280 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F333506NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital of the Kings Daughters Inc CurrentSince Jun 10, 2017 Accepting new patients
Childrens Specialty Group PLLC Pediatrics CurrentSince Jun 1, 2024 Accepting new patients

Locations

817 Volvo Pkwy
Chesapeake, VA 23320
Phone (757) 668-4630

680 Oyster Point Rd
Newport News, VA 23606
Phone (757) 668-4673

850 Southampton Ave
Norfolk, VA 23510
Phone (757) 668-4673

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

1924 Landstown Centre Way
Virginia Beach, VA 23456
Phone (757) 668-4673

2021 Concert Dr
Virginia Beach, VA 23456
Phone (757) 668-6550

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1972675841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910",
            "telephone_number": "757-668-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23507",
            "telephone_number": "576-688-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "TRACY",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174742",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "F333506",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02762825",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.