Lacey Starr Graham, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-153271 Issued in AL

Practice address

2391 Highway 78
Dora, AL 35062-5233

Phone

(205) 255-7052

NPI assigned

Feb 25, 2021

Last updated

Feb 25, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• QV Urgent Care TX PLLC

  dba QuickVisit Urgent Care

  • Family Medicine Physician
  • Henderson, TX
  • NPI 1568098887
  NPD
• QV Urgent Care TX PLLC

  dba QuickVisit Urgent Care

  • Rural Health Clinic/Center
  • Madisonville, TX
  • NPI 1669198347
  NPD

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1124612510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 CAMELLIA LN",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "351736322",
            "telephone_number": "205-243-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2391 HIGHWAY 78",
            "city": "DORA",
            "state": "AL",
            "postal_code": "350625233",
            "telephone_number": "205-255-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "LACEY",
        "middle_name": "STARR",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-153271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Allan Dixon, MD
• Dora Discount Pharmacy, Inc
• Gateway Health Center, LLC
• Kenneth Samuel Glover II, RPH
• Ashley Godfrey, NP-C
• Robert C Henslee, PHARMD
• Kenneth Samuel Glover II (Ken Glover Drug)
• Mark A Knight, RN
• Maria Lively, RPH
• Brooke Diane Loveless-Yates, CRNP

• Family Nurse Practitioner in Dora, AL
• Providers in Dora, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.