NPIMap

Individual provider Active NPI

Wesley Grayson Lackey, M.D.

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1033314984
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
01071508A Issued in IN
Practice address
6920 Gatwick Dr
Suite 200
Indianapolis, IN 46241-9504
Phone
(317) 455-1064
Fax
(317) 455-1204
NPI assigned
Jun 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X LL29757 SC
Orthopaedic Surgery Physician 207X00000X 01071508A IN Primary

Addresses

Primary practice location

6920 Gatwick Dr
Suite 200
Indianapolis, IN 46241-9504

Mailing address

3600 W Bethel Ave
Muncie, IN 47304-5407

Other practice location 1

541 S Landmark Ave
Bloomington, IN 47403-3239
Phone (317) 455-1064

Other practice location 2

3051 S US Highway 41
Terre Haute, IN 47802-3791
Phone (317) 455-1064

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130314000447 IN Practitioner - Orthopedic Surgery 8224273560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Indiana University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cutting Edge Physical Therapy Limited PartnershipGroup PAC ID 6406869163, 109 clinicians
Central Indiana Orthopedics LLCGroup PAC ID 5698667822, 148 clinicians

Practice addresses (Care Compare)

2390 National Rd W
Richmond, IN 47374-4625

6920 Gatwick Dr
Suite 200
Indianapolis, IN 46241-9619
Phone (317) 455-1064

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.81 of 100Reported as group
Quality
64.48
Promoting interoperability
96
Improvement activities
40
Cost
78.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement69
Knee replacement91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01071508AINMDOrthopaedic Surgery Physician
LL29757SCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Indiana Orthopedics LLC Orthopaedic Surgery CurrentSince Apr 1, 2023 Accepting new patients
Bloomington Advanced Surgery Center, LLC CurrentSince Sep 14, 2021 Accepting new patients
Central Indiana Orthopedics, LLC Orthopaedic Surgery CurrentSince Apr 1, 2023 Accepting new patients
Major Hospital Past Accepting new patients

Locations

445 S Landmark Ave
Bloomington, IN 47403
Phone (812) 353-3450

541 S Landmark Ave
Bloomington, IN 47403
Phone (317) 455-1064

6920 Gatwick Dr
Ste 200
Indianapolis, IN 46241
Phone (317) 455-1064

3600 W Bethel Ave
Muncie, IN 47304
Phone (765) 213-3870

3051 S US Highway 41
Terre Haute, IN 47802
Phone (317) 455-1064

Interoperability endpoints

  • Direct secure messaging: wesley.lackey.p4@direct.beaconortho.nextgenshare.com
  • Direct secure messaging: wlackey96106@direct.franciscanalliance.org

Organizations & group practices 5

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1033314984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6920 GATWICK DR",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462419504",
            "telephone_number": "317-455-1064",
            "fax_number": "317-455-1204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "541 S Landmark Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474033239",
            "country_code": "US",
            "telephone_number": "317-455-1064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3051 S US Highway 41",
            "address_purpose": "LOCATION",
            "city": "Terre Haute",
            "state": "IN",
            "postal_code": "478023791",
            "country_code": "US",
            "telephone_number": "317-455-1064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "WESLEY",
        "middle_name": "GRAYSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "LL29757",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01071508A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.