Lacey Lynne Roberts, BS PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT936 Issued in AR

Practice address

231 Herbert Dr
Hensley, AR 72065-9512

Phone

(501) 888-3229

Fax

(501) 888-3229

NPI assigned

Mar 23, 2006

Last updated

Feb 26, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1194785444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 HERBERT DR",
            "city": "HENSLEY",
            "state": "AR",
            "postal_code": "720659512",
            "telephone_number": "501-888-3229",
            "fax_number": "501-888-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 HERBERT DR",
            "city": "HENSLEY",
            "state": "AR",
            "postal_code": "720659512",
            "telephone_number": "501-888-3229",
            "fax_number": "501-888-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LACEY",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "BS PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16607721",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5S380",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Hensley, AR
• Providers in Hensley, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.