Individual provider Active NPI

Lakeva Casey

  • Pediatric Nurse Practitioner
  • Florence, AL
National Provider Identifier
1255705000
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1-130759 Issued in AL
Practice address
2530 Florence Blvd Ste D
Florence, AL 35630-2807
Phone
(568) 021-5002
Fax
(256) 802-1501
NPI assigned
Nov 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1130759 AL
Pediatric Nurse Practitioner 363LP0200X 1-130759 AL Primary

Addresses

Primary practice location

2530 Florence Blvd Ste D
Florence, AL 35630-2807

Mailing address

PO Box 2874
Florence, AL 35630-0022
Phone (256) 802-1500

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1130759ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kids First Pediatric Urgent Care, LLC CurrentSince Apr 26, 2020 Accepting new patients
Tennessee Valley Pediatric Associatesinc. Past Accepting new patients

Locations

2530 Florence Blvd
Ste D
Florence, AL 35630
Phone (256) 760-4390

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": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1255705000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2874",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356300022",
            "telephone_number": "256-802-1500",
            "fax_number": "256-802-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 FLORENCE BLVD STE D",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356302807",
            "telephone_number": "568-021-5002",
            "fax_number": "256-802-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "LAKEVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1130759",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-130759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.

Verify at the official NPI Registry.