Active NPI
Lacey Rae Golick, PA
- Physician Assistant
- Apex, NC
National Provider Identifier
1174229892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-13085
- Practice address
- 1430 Doverside Dr
Apex, NC 27523-6429 - Phone
- (724) 554-4141
- NPI assigned
- Feb 3, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-13085 | NC | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1430 Doverside Dr
Apex, NC 27523-6429
Mailing address
1430 Doverside Dr
Apex, NC 27523-6429
Phone (724) 554-4141
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-13085 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rex Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Raleigh, NC
- NPI 1972939643
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722384000000",
"number": "1174229892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1430 DOVERSIDE DR",
"city": "APEX",
"state": "NC",
"postal_code": "275236429",
"telephone_number": "724-554-4141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1430 DOVERSIDE DR",
"city": "APEX",
"state": "NC",
"postal_code": "275236429",
"telephone_number": "724-554-4141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLICK",
"first_name": "LACEY",
"middle_name": "RAE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-03",
"last_updated": "2024-07-31",
"certification_date": "2024-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-13085",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apex, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.