Provider Type Icon

DR. JERRY ALLEN LUCAS MD NPI 1912016742


NPI Information

NPI: 1912016742
Provider Name: DR. JERRY ALLEN LUCAS, MD
Classification: Obstetrics & Gynecology - 207VX0000X
Entity Type: Individual

Specialization: Obstetrics

Organization: JOHN RANDOLPH OB GYN LLC

PECOS Registration: Yes

Address:
5204 PAULSEN ST
SAVANNAH, GA
ZIP 31405
Phone: (000) 000-0000
Get Directions

DR. Jerry Allen Lucas, MD is an obstetrics obstetrics gynecology in Savannah, GA with 31 years of experience. DR. Jerry Allen Lucas, MD NPI is 1912016742. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Graduation Year:1993

The provider's business location address is:

5204 PAULSEN ST
SAVANNAH, GA
ZIP 31405-704
Phone: (000) 000-0000

The NPI 1912016742 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasound pelvis through vagina (HCPCS:76830)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

The enumeration date for this NPI number is 8/29/2006 and was last updated on 2/4/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VX0000XObstetrics & GynecologyObstetrics90992GEORGIAYes
2207V00000XObstetrics & Gynecology0101055788VIRGINIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
190992OTHERGEORGIASTATE LICENSE
2160043283QOTHERVIRGINIARAILROAD MEDICARE ID#
3006210082MEDICAIDVIRGINIA
4271664OTHERVIRGINIAANTHEM BC/BS ID#
5541467765OTHERVIRGINIATAX ID#
645748OTHERVIRGINIAOPTIMA SENTARA ID#
7952279OTHERVIRGINIAAETNA ID#
820507OTHERVIRGINIAVIRGINIA PREMIER ID #
95414523OTHERVIRGINIAAETNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.