Active NPI
Lacey Elizabeth Robertson, PHARM D
- Pharmacist
- Blacksburg, VA
National Provider Identifier
1184228595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202210765
- Practice address
- 600 University City Blvd
Blacksburg, VA 24060-2757 - Phone
- (540) 951-4911
- NPI assigned
- Nov 25, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202210765 | VA | Primary |
Addresses
Primary practice location
600 University City Blvd
Blacksburg, VA 24060-2757
Mailing address
600 University City Blvd
Blacksburg, VA 24060-2757
Phone (540) 951-4911
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202210765 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Virginia CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
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": "1606262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606262400000",
"number": "1184228595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 UNIVERSITY CITY BLVD",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "240602757",
"telephone_number": "540-951-4911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 UNIVERSITY CITY BLVD",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "240602757",
"telephone_number": "540-951-4911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "LACEY",
"middle_name": "ELIZABETH",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-25",
"last_updated": "2020-11-25",
"certification_date": "2020-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202210765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blacksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.