Lacey Colvin, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

VA0116030247 Issued in VA

Practice address

3700 S Main St
Blacksburg, VA 24060-7017

Phone

(850) 628-0877

NPI assigned

Mar 24, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Internal Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Statesboro Hma Physician Management LLCGroup PAC ID 8820196058, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lacey.colvin@hca6.eclinicaldirectplus.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.

• Statesboro Hma Physician Management LLC

  • Hospitalist Physician
  • Statesboro, GA
  • NPI 1558412023
  Medicare reassignment Care Compare group NPD
• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  NPD (past)
• Strength Medical Group, LLC

  • General Practice Physician
  • Panama City, FL
  • NPI 1275257305
  NPD (past)

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

• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1184155707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 BAKER DR",
            "city": "VINTON",
            "state": "VA",
            "postal_code": "241791602",
            "telephone_number": "850-628-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 S MAIN ST",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607017",
            "telephone_number": "850-628-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVIN",
        "first_name": "LACEY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0116030247",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "VA0116030247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Moore Collins, RPH
• Ann Shaw Collins, DO
• Sara Moriah Collins, COTA/L
• Sean Collins
• Colliver Sports & Spine Inc
• Elisabeth G. Combs, DMD
• Commonwealth Hospitalist Group, LLC
• Bettina Comparativo
• Joseph Howard Conduff III, MD
• Richard Conley

• Internal Medicine Physician in Blacksburg, VA
• Providers in Blacksburg, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.