Individual provider Active NPI

John Lacson

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1104313634
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
009179 Issued in AZ
Practice address
2927 N 7TH Ave
Phoenix, AZ 85013-4102
Phone
(602) 406-3153
Fax
(602) 406-7176
NPI assigned
Apr 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT18912 PA
Family Medicine Physician 207Q00000X 009179 AZ Primary

Addresses

Primary practice location

2927 N 7TH Ave
Phoenix, AZ 85013-4102

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address john.lacson.1@29601.direct.athenahealth.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250401000264 GA Practitioner - Family Practice 5294088837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centerwell Senior Primary Care Ga PCGroup PAC ID 3274939061, 56 clinicians

Practice addresses (Care Compare)

3435 Wrightsboro Rd
Suite 1202
Augusta, GA 30909-2519
Phone (706) 445-2349

Hospital & facility affiliations

  • Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028
  • Doctors Hospital Hospital, Augusta, GA, CCN 110177
  • Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
009179AZMDFamily Medicine Physician
OT18912PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care Ga PC Family Medicine CurrentSince May 12, 2025 Accepting new patients
Centerwell Senior Primary Care Ga PC Family Medicine Current Accepting new patients
Centerwell Senior Primary Care Ga PC Family Medicine CurrentSince May 12, 2025 Accepting new patients
Centerwell Senior Primary Care Ga PC Family Medicine Past Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

3435 Wrightsboro Rd
Ste 1202
Augusta, GA 30909
Phone (706) 445-2349

1821 Mount Zion Rd
Morrow, GA 30260
Phone (470) 754-6380

Interoperability endpoints

  • Direct secure messaging: john.lacson.1@29601.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1104313634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 N 7TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134102",
            "telephone_number": "602-406-3153",
            "fax_number": "602-406-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACSON",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT18912",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "009179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.lacson.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3435 Wrightsboro Rd",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309092518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.