Individual provider Active NPI

Christopher J Lucas, D.O.

  • Vascular Surgery Physician
  • Clarksville, TN
National Provider Identifier
1982632337
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
DO0000001524 Issued in TN
Practice address
647 Dunlop LN 203
Clarksville, TN 37040-5165
Phone
(931) 502-3700
Fax
(931) 502-3705
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X DO0000001524 TN
Vascular Surgery Physician 2086S0129X DO0000001524 TN Primary

Addresses

Primary practice location

647 Dunlop LN 203
Clarksville, TN 37040-5165

Mailing address

647 Dunlop LN 203
Clarksville, TN 37040-5165
Phone (931) 502-3700

Other identifiers 1

IdentifierTypeStateIssuer
3307461MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christopher.lucas.1@1879.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081002000166 TN Practitioner - General Surgery 2062580152 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1524TNMDProfessional Counselor
DO0000001524TNMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clarksville Physician Services LLC CurrentSince Aug 1, 2008 Accepting new patients
Clarksville Physician Services, LLC Past Accepting new patients
Tennessee Heart and Lung Institute PLC Specialist Past Accepting new patients

Locations

647 Dunlop Ln
Ste 206
Clarksville, TN 37040
Phone (931) 232-5141

647 Dunlop Ln
Ste 210
Clarksville, TN 37040
Phone (931) 502-3810

647 Dunlop Ln
Ste 203
Clarksville, TN 37040
Phone (931) 502-3700

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

647 Dunlop Ln
Ste 100
Clarksville, TN 37040
Phone (931) 551-8991

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1879/brand/1/csg/1/fhir/r4
  • Direct secure messaging: christopher.lucas.1@1879.direct.athenahealth.com

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1982632337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 DUNLOP LN 203",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405165",
            "telephone_number": "931-502-3700",
            "fax_number": "931-502-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 DUNLOP LN 203",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405165",
            "telephone_number": "931-502-3700",
            "fax_number": "931-502-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "DO0000001524",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "DO0000001524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3307461",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christopher.lucas.1@1879.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "647 DUNLOP LN 203",
            "city": "CLARKSVILLE",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370405165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.