Annabel Lackey, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

71009680A Issued in IN

Practice address

3834 S Emerson Ave
Indianapolis, IN 46203-5901

Phone

(317) 781-2009

NPI assigned

Jul 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Advanced Healthcare Associates LLP

  • Geriatric Medicine (Internal Medicine) Physician
  • Elwood, IN
  • NPI 1841225091

  Gerontology

  Medicare reassignment NPD
• Altea Medical Indiana PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Gary, IN
  • NPI 1992584783
  Medicare reassignment NPD
• Cleanslate Medical Group of Indiana LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Alexandria, IN
  • NPI 1023464294
  Medicare reassignment NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  IN

  Medicare reassignment NPD

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1275186892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3834 S EMERSON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462035901",
            "telephone_number": "317-781-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3834 S EMERSON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462035901",
            "telephone_number": "317-781-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "ANNABEL",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71009680A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28163199A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marco A Lacerda, M.D.
• Melissa A Lachajewski, PSYD
• Gavin Foley Lachat
• Theresa Lacher, PT
• Jordon Lachowecki, MD
• Wesley Grayson Lackey, M.D.
• Tyler Nicole Lackland, MD
• Linn Susan Laclave, PHD
• Kayla Lacombe
• Andrea Lacson

• Gerontology Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.