DR. LISA R. LUCKEY (NPI# 1508008772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508008772 |
| Entity Type | Individual |
| Full Name | DR. LISA R. LUCKEY |
| Credential | D.O. |
| Practice Address |
13644 Walsingham Rd Largo FL 33774-3532 |
| Practice Telephone | 7275952519 |
| Practice Fax Number | 7275939904 |
| Mailing Telephone | 7275952519 |
| Mailing Fax Number | 7275939904 |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2015-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | OS 10452 | FL | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
OS10452 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | CIGNA | 5799464 | 01 |
| FL | 1508008772 | 05 | |
| FL | WELLMED | 21924001 | 01 |
| FL | AVMED | 342337 | 01 |
| FL | COVENTRY | 2013366 | 01 |
| FL | UNIVERSAL | 232988 | 01 |
| FL | AETNA | 9269370 | 01 |
| FL | WELLMED | 21924002 | 01 |
| Street Address |
13644 WALSINGHAM RD |
| City | LARGO |
| State | FL |
| Zip Code | 33774-3532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912909797 | Michael David Riley | Otolaryngology | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2005-08-11 |
| 1053746479 | Brenton Daniel Mccoy | Internal Medicine | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2013-09-04 |
| 1578826954 | Peggy Ann Cordle | Internal Medicine | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2012-06-20 |
| 1508175530 | Leo Choe | Internal Medicine | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2010-09-24 |
| 1811182975 | Suncoast Internal Medicine Consultants | Internal Medicine | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2007-09-12 |
| 1902091069 | Suncoast Internal Medicine Consultants | Internal Medicine | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2007-09-12 |
| 1013057090 | Suncoast Internal Medicine Consultants | Clinical Medical Laboratory | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2007-02-07 |
| 1992794986 | Dane Maxfield | Internal Medicine | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2005-10-21 |
| 1770572778 | Robert Digiovanni | Internal Medicine | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2005-10-21 |
| 1023007028 | Randal G Worth | Internal Medicine | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2005-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467930818 | Anthea Marina Dsouza | Physical Therapist | 3500 Oak Manor Lane, Largo, FL 33774 | 2018-07-29 |
| 1265918874 | Bertishia Lashanti Mosley | Home Health | 2308 Fulton Way, Largo, FL 33774 | 2018-07-17 |
| 1639660699 | Tanya Jadhav | Dentist | 12963 Walsingham Rd, Largo, FL 33774 | 2018-05-25 |
| 1588001390 | Lindsay Erin Spotts | Dietitian, Registered | 14763 Sunset Drive, Largo, FL 33774 | 2013-06-03 |
| 1235572314 | Jasmine Gardens LLC | Assisted Living Facility | 11355 131st St, Largo, FL 33774 | 2013-04-09 |
| 1033484183 | The Body Masters, Inc | Massage Therapist | 12552 Indian Rocks Road, Largo, FL 33774 | 2012-03-21 |
| 1902112923 | Christie Youssef | Family Medicine | 2025 Indian Rocks Rd., Largo, FL 33774 | 2010-08-27 |
| 1568777548 | Lee Laravia | General Practice | 2025 Indian Rocks Rd, Largo, FL 33774 | 2010-08-13 |
| 1699957068 | Indian Oaks Incorporated | Assisted Living Facility | 11355 131st Street North, Largo, FL 33774 | 2007-11-28 |
| 1487867164 | Eric Nathan Grosch | Internal Medicine | 11800 Hammock Drive, Largo, FL 33774 | 2007-05-08 |
| Find all providers in zip 33774 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689654725 | Miriam R Thomas | Internal Medicine | 8250 Bryan Dairy Rd Ste 200, Largo, FL 33777-1359 | 2006-01-17 |
| 1487646154 | John Wycliff Bedeau | Internal Medicine | 9301 Largo Drive West Suite 201, Largo, MD 20774-4884 | 2005-08-18 |
| 1063417285 | Largo Endoscopy Center Lp | Internal Medicine | 7300 Bryan Dairy Road, Suite 495, Largo, FL 33777 | 2005-06-15 |
| 1881054161 | Meir Mizrahi | Internal Medicine | 8250 Bryan Dairy Rd Ste 200, Largo, FL 33777-1359 | 2016-03-01 |
| 1790193100 | Bilal Aslam | Internal Medicine | 8250 Bryan Dairy Rd, Largo, FL 33777-1353 | 2014-07-29 |
| 1417233818 | Aj Bidani, M.d. Pa | Internal Medicine | 8787 Bryan Dairy Rd, Ste 310, Largo, FL 33777-1251 | 2011-10-29 |
| 1477729408 | Nirmala Sivaprakasapillai | Internal Medicine | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2008-04-30 |
| 1811182975 | Suncoast Internal Medicine Consultants | Internal Medicine | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2007-09-12 |
| 1922210582 | Justin R. Nudell | Internal Medicine | 8250 Bryan Dairy Rd, Suite 200, Largo, FL 33777-1353 | 2007-05-04 |
| 1720156730 | Peter Ritka | Internal Medicine | 1221 Mercantile Lane, Largo, MD 20774-5374 | 2006-11-30 |
| Find all providers in LARGO | ||||
Please comment or provide details below to improve the information on DR. LISA R. LUCKEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.