Individual provider Active NPI

Lacy Viertel

  • Physical Therapist
  • Abilene, TX
National Provider Identifier
1174993489
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1229486 Issued in TX
Practice address
1602 S Clack St
Abilene, TX 79605-4610
Phone
(325) 691-0093
NPI assigned
Sep 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1229486 TX Primary

Addresses

Primary practice location

1602 S Clack St
Abilene, TX 79605-4610

Mailing address

1602 S Clack St
Abilene, TX 79605-4610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171016002875 TX Practitioner - Physical Therapist in Private Practice 7214203454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 Hill St
Albany, TX 76430-3165
Phone (806) 470-2858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1229486TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Physical Therapy LTD Co Physical Therapist CurrentSince Feb 1, 2020 Accepting new patients
Big Country Rehabilitation Inc Past Accepting new patients
Privia Medical Group West Texas, PLLC Past Accepting new patients

Locations

201 Hill St
Albany, TX 76430
Phone (806) 470-2858

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1174993489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 S CLACK ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 S CLACK ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054610",
            "telephone_number": "325-691-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIERTEL",
        "first_name": "LACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1229486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.