Individual provider Active NPI

Shazia Lackey, APRN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1083257398
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP143474 Issued in TX
Practice address
4120 N Collins St Ste 200
Arlington, TX 76005-4554
Phone
(817) 372-2283
NPI assigned
Oct 21, 2019
Last updated
Jan 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP143474 TX Primary

Addresses

Primary practice location

4120 N Collins St Ste 200
Arlington, TX 76005-4554

Mailing address

2104 Coolidge Dr
Arlington, TX 76011-3206
Phone (817) 312-3396

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
AP143474TXMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1083257398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 COOLIDGE DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760113206",
            "telephone_number": "817-312-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 N COLLINS ST STE 200",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760054554",
            "telephone_number": "817-372-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "SHAZIA",
        "credential": "APRN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP143474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.