Individual provider Active NPI

Lacey N Roberts, APRN, FNP-C

  • Family Nurse Practitioner
  • Henderson, KY
National Provider Identifier
1033468632
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3007612 Issued in KY
Practice address
110 Third St
Suite 250
Henderson, KY 42420
Phone
(270) 826-0135
Fax
(270) 827-8798
NPI assigned
Aug 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3007612 KY Primary

Addresses

Primary practice location

110 Third St
Suite 250
Henderson, KY 42420

Mailing address

PO Box 1079
Henderson, KY 42419-1079
Phone (270) 827-0353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1033468632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1079",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424191079",
            "telephone_number": "270-827-0353",
            "fax_number": "270-827-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 THIRD ST",
            "address_2": "SUITE 250",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "42420",
            "telephone_number": "270-826-0135",
            "fax_number": "270-827-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LACEY",
        "middle_name": "N",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.