Davon Lackie

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

A004220 Issued in AR

Practice address

103 Woodlane Dr
Searcy, AR 72143-6113

Phone

(501) 268-3733

NPI assigned

Feb 5, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• St. Vincent Infirmary Medical Center

  • Certified Registered Nurse Anesthetist
  • Sherwood, AR
  • NPI 1316991847
  Medicare reassignment NPD
• St. Vincent Medical Group

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1134176480
  Medicare reassignment
• Heart Clinic Arkansas

  • Cardiovascular Disease Physician
  • Little Rock, AR
  • NPI 1053367508
  NPD
• St Vincent Infirmary Medical Center

  • Psychiatric Hospital Unit
  • Little Rock, AR
  • NPI 1710442801
  NPD
• St. Vincent Infirmary Medical Center

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1144590522
  NPD

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1063803567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WOODLANE DR",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721436113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WOODLANE DR",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721436113",
            "telephone_number": "501-268-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKIE",
        "first_name": "DAVON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A004220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nivritti Kumaran, D.O.
• Lab of Path, PA
• Lab of Path, PA
• Rena Michele Labeaud-Howard, PHARMD
• Christine Labonne
• Laura Ladd
• Gregory Laffoon, MD
• Sydney Lynanne Jude Laird, DPT
• Virgil R Lambeth, EDD, ATC, LAT
• Eric Landa, MD

• Acute Care Nurse Practitioner in Searcy, AR
• Providers in Searcy, AR by specialty
• Acute Care Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.