Mary J Lacy, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN131464 Issued in GA

Practice address

310 Kennestone Hospital Blvd
Marietta, GA 30060-1120

Phone

(770) 793-7856

Fax

(770) 793-7856

NPI assigned

Sep 27, 2005

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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascend Medical Georgia II PCGroup PAC ID 0547657181, 16 clinicians

Ascend Medical Georgia PCGroup PAC ID 8820488745, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.lacy.1@30437.direct.athenahealth.com

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.

• Ascend Medical Georgia II PC

  • Psychiatry Physician
  • Atlanta, GA
  • NPI 1659966075
  Medicare reassignment Care Compare group NPD
• Ascend Medical Georgia PC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1841800836
  Medicare reassignment Care Compare group NPD
• Vitas Healthcare Corporation of Georgia

  • Community Based Hospice Care Agency
  • Atlanta, GA
  • NPI 1932242260
  NPD

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1093701781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 KENNESTONE HOSPITAL BLVD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601120",
            "telephone_number": "770-793-7856",
            "fax_number": "770-793-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 KENNESTONE HOSPITAL BLVD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601120",
            "telephone_number": "770-793-7856",
            "fax_number": "770-793-7856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5670 Peachtree Dunwoody Rd",
            "address_2": "Suite 1000",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421699",
            "country_code": "US",
            "telephone_number": "404-255-1930 x1156",
            "fax_number": "404-459-8510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACY",
        "first_name": "MARY",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN131464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "962062906A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "962062906C",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlacy608061@directwellstar.org",
            "affiliation": "N",
            "address_1": "310 Kennestone Hospital Blvd",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lacey Drug Co., Inc. (Lacey's Marietta Pharmacy)
• Lacey Drug Company Inc (Lacey's Marietta Pharmacy)
• Lacy Holland Lacey, AGACNP-BC
• Vicki Posey Lackey, M.S. BCBA
• Vuk Lacmanovic, MD
• Robyn Ladinsky
• Melissa Lafontaine
• Emily Laga, OD
• Emily Lagergren, MD
• Ellen Laghaie

• Family Nurse Practitioner in Marietta, GA
• Providers in Marietta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.