Individual provider Active NPI

David William Lacey, MD

  • Physical Medicine & Rehabilitation Physician
  • Fishersville, VA
National Provider Identifier
1205838968
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0101267148 Issued in VA
Practice address
70 Medical Center Cir Ste 302
Fishersville, VA 22939-2273
Phone
(540) 245-7400
Fax
(540) 245-7401
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 0101267148 VA Primary
Neurology Physician 2084N0400X 2009-01893 NC

Addresses

Primary practice location

70 Medical Center Cir Ste 302
Fishersville, VA 22939-2273

Mailing address

PO Box 388
Fishersville, VA 22939-0388
Phone (540) 932-5162

Other practice location 1

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2255

Other identifiers 2

IdentifierTypeStateIssuer
0982950MedicaidOH
890676XMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091120000556 NC Practitioner - Physical Medicine and Rehabilitation 4587764311
I20190725000883 VA Practitioner - Physical Medicine and Rehabilitation 4587764311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35063931OHMDGastroenterology Physician
2009-01893NCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Sleep Centers, PLLC PastSince Sep 24, 2012 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.

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1205838968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388",
            "telephone_number": "540-932-5162",
            "fax_number": "540-932-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER CIR STE 302",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392273",
            "telephone_number": "540-245-7400",
            "fax_number": "540-245-7401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271570001",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "fax_number": "336-713-8588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACEY",
        "first_name": "DAVID",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101267148",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2009-01893",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0982950",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890676X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.