Individual provider Active NPI

Lacy N Thomas, LDO,ABOC

  • Optician
  • Fort Smith, AR
National Provider Identifier
1063135812
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
L-120107 Issued in AR
Practice address
8301 Rogers Ave
Fort Smith, AR 72903-5236
Phone
(479) 478-6241
Fax
(479) 478-6753
NPI assigned
Sep 26, 2022
Last updated
Sep 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X L-120107 AR Primary

Addresses

Primary practice location

8301 Rogers Ave
Fort Smith, AR 72903-5236

Mailing address

8301 Rogers Ave
Fort Smith, AR 72903-5236
Phone (479) 478-6241

Other names 1

  • Miss Lacy N South Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address LNSOUTH.S00141@US.WAL-MART.COM Direct

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L-120107ARMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1063135812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035236",
            "telephone_number": "479-478-6241",
            "fax_number": "479-478-6753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035236",
            "telephone_number": "479-478-6241",
            "fax_number": "479-478-6753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "LACY",
        "middle_name": "N",
        "credential": "LDO,ABOC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "AR",
            "license": "L-120107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LNSOUTH.S00141@US.WAL-MART.COM",
            "affiliation": "N",
            "endpointDescription": "COMPANY EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8301 Rogers Ave",
            "city": "Fort Smith",
            "state": "AR",
            "country_code": "US",
            "postal_code": "729035236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LACY",
            "last_name": "SOUTH",
            "middle_name": "N",
            "prefix": "MISS",
            "credential": "LDO,ABOC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.