Lacey Hedges OD LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

LACEY HEDGES OD LLC

Practice address

1350 S Seward Meridian Pkwy
Wasilla, AK 99654-8332

Phone

(907) 376-0835

Fax

(907) 376-0843

NPI assigned

Nov 16, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Lacey Hedges, ODNPI 1952658023

Title

Owner

Phone

(316) 323-4805

Specialties & licenses 1

Addresses

Other names 1

• Lacey Hedges OD LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lacey Dawn Hedges, OD

  • Optometrist
  • Kansas City, MO
  • NPI 1952658023

  AK

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1083323216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S SEWARD MERIDIAN PKWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548332",
            "telephone_number": "907-376-0835",
            "fax_number": "907-376-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S SEWARD MERIDIAN PKWY",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548332",
            "telephone_number": "907-376-0835",
            "fax_number": "907-376-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACEY HEDGES OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "HEDGES",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-323-4805",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lacey Hedges OD LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Barth Kulpa
• Emily Kuntz
• Janette Kristine Kutzner
• Katelyn Kuzmin
• Labor of Love Midwifery, LLC
• Michelle Elaine Lacey, DPT
• Amy Marie Lacher, BCBA
• Ellisa Lacy, LPN
• Matthew A Ladner
• Leslie Lajeunesse, APRN

• Health Service Clinic/Center in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Health Service Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.