Active NPI
Lacey Pappan, PT, DPT
- Physical Therapist
- Skiatook, OK
National Provider Identifier
1215368261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4494
- Practice address
- 1355 W Rogers Blvd
10
Skiatook, OK 74070-4204 - Phone
- (918) 333-5100
- Fax
- (918) 333-5102
- NPI assigned
- Dec 2, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4494 | OK | Primary |
Addresses
Primary practice location
1355 W Rogers Blvd
10
Skiatook, OK 74070-4204
Mailing address
PO Box 3008
Bartlesville, OK 74006-3008
Phone (918) 333-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200522010 | Medicaid | OK |
Other names 1
- Miss Lacey Adams
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4494 | OK | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396396800000",
"number": "1215368261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3008",
"city": "BARTLESVILLE",
"state": "OK",
"postal_code": "740063008",
"telephone_number": "918-333-5100",
"fax_number": "918-333-5102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1355 W ROGERS BLVD",
"address_2": "10",
"city": "SKIATOOK",
"state": "OK",
"postal_code": "740704204",
"telephone_number": "918-333-5100",
"fax_number": "918-333-5102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAPPAN",
"first_name": "LACEY",
"name_prefix": "Mrs.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-02",
"last_updated": "2014-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "4494",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200522010",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LACEY",
"last_name": "ADAMS",
"prefix": "MISS",
"credential": "PT, DPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Skiatook, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.