Lacy Wilkerson, MD

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

Practice address

1015 FM 272
Celeste, TX 75423-6248

Phone

(615) 208-0663

NPI assigned

May 24, 2024

Last updated

May 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Lacy Rae Wilkerson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1003655317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 FM 272",
            "city": "CELESTE",
            "state": "TX",
            "postal_code": "754236248",
            "telephone_number": "615-208-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 FM 272",
            "city": "CELESTE",
            "state": "TX",
            "postal_code": "754236248",
            "telephone_number": "615-208-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "LACY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACY",
            "last_name": "WILKERSON",
            "middle_name": "RAE",
            "credential": "LACY RAE HILL",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Celeste Isd
• Carol Mendoza, LPC
• Erica Resseguie, PTA
• Joanne Y Rhodes
• Savannah Stone
• Brenda Yates, RN

• Prescribing (Medical) Psychologist in Celeste, TX
• Providers in Celeste, TX by specialty
• Prescribing (Medical) Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.