Active NPI
Lacy Hildebran
- Pediatric Occupational Therapist
- Hickory, NC
National Provider Identifier
1285500405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 18075
- Practice address
- 1040 Southgate Corporate Park SW
Hickory, NC 28602-1518 - Phone
- (828) 358-3115
- NPI assigned
- Oct 14, 2025
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 18075 | NC | Primary |
Addresses
Primary practice location
1040 Southgate Corporate Park SW
Hickory, NC 28602-1518
Mailing address
1040 Southgate Corporate Park SW
Hickory, NC 28602-1518
Phone (828) 358-3115
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18075 | NC | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy Network | Pediatrics | Current | Accepting new patients |
Locations
1040 Southgate Corporate Park SW
Hickory, NC 28602
Phone (828) 358-3115
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": "1760400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786060800000",
"number": "1285500405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 SOUTHGATE CORPORATE PARK SW",
"city": "HICKORY",
"state": "NC",
"postal_code": "286021518",
"telephone_number": "828-358-3115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 SOUTHGATE CORPORATE PARK SW",
"city": "HICKORY",
"state": "NC",
"postal_code": "286021518",
"telephone_number": "828-358-3115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILDEBRAN",
"first_name": "LACY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-10-14",
"last_updated": "2026-08-07",
"certification_date": "2026-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NC",
"license": "18075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hickory, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.