Organization Active NPI

Lacy Coker Kessler, MD, PA

  • Obstetrics & Gynecology Physician
  • Waco, TX
National Provider Identifier
1003177726
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
P2879 Issued in TX
Legal business name
LACY COKER KESSLER, MD, PA
Practice address
2420 Wycon Dr Ste 403
Waco, TX 76712-8988
Phone
(254) 420-0002
NPI assigned
May 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Authorized official

Name
Sarah J Elliott
Title
Office Manager
Phone
(254) 420-0002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X P2879 TX Primary

Addresses

Primary practice location

2420 Wycon Dr Ste 403
Waco, TX 76712-8988

Mailing address

2420 Wycon Dr
Suite 403
Waco, TX 76712-8987
Phone (254) 420-0002

Other identifiers 1

IdentifierTypeStateIssuer
3064149-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120726000712 TX Part B Supplier - Clinic/Group Practice 1153587688 Receives reassigned benefits from 6 practitioners
Practice locations: Waco, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2047764Lacy Coker Kessler MD PA2420 Wycon Dr., Suite 403, Waco, TX 76712Provider-performed microscopyFeb 21, 2027

National Provider Directory

National Provider Directory

Locations

2420 Wycon Dr
Ste 403
Woodway, TX 76712
Phone (254) 420-0002

2410 Wycon Dr
Ste 204
Woodway, TX 76712
Phone (254) 752-9221

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1003177726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 WYCON DR",
            "address_2": "SUITE 403",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128987",
            "telephone_number": "254-420-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 WYCON DR STE 403",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128988",
            "telephone_number": "254-420-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACY COKER KESSLER, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-30",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "254-420-0002"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P2879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3064149-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.