Individual provider Active NPI

Lacey Edwards Hartz, NNP

  • Critical Care Neonatal Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1033585054
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
5020744 Issued in NC
Practice address
1001 Blythe Blvd Ste 200
Charlotte, NC 28203-5865
Phone
(704) 381-4820
NPI assigned
Aug 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X RN1033864 DC
Critical Care Neonatal Nurse Practitioner 363LN0005X RN2315093 MA
Critical Care Neonatal Nurse Practitioner 363LN0005X 5020744 NC Primary

Addresses

Primary practice location

1001 Blythe Blvd Ste 200
Charlotte, NC 28203-5865

Mailing address

1001 Blythe Blvd Ste 200
Charlotte, NC 28203-5865
Phone (704) 381-4820

Other names 1

  • Lacey Nicole Edwards Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241112002756 NC Practitioner - Nurse Practitioner 5193025823 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN1033864DCMDNeonatal Nurse Practitioner
RN2315093MAMDCritical Care Neonatal Nurse Practitioner
5020744NCMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Oct 7, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Oct 7, 2024 Accepting new patients

Locations

1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

Interoperability endpoints

  • Direct secure messaging: lhartz251838@direct.bilh.masshiway.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1033585054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035865",
            "telephone_number": "704-381-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035865",
            "telephone_number": "704-381-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTZ",
        "first_name": "LACEY",
        "middle_name": "EDWARDS",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "DC",
            "license": "RN1033864",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "MA",
            "license": "RN2315093",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "NC",
            "license": "5020744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "EDWARDS",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.