Individual provider Active NPI

Erika Nicole Lackey

  • Chiropractor
  • Portsmouth, VA
National Provider Identifier
1295241396
Registry record updated Dec 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104557450 Issued in VA
Practice address
355 Crawford St Ste 105
Portsmouth, VA 23704-2832
Phone
(757) 399-4700
Fax
(757) 399-0011
NPI assigned
Dec 27, 2017
Last updated
Dec 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104557450 VA Primary

Addresses

Primary practice location

355 Crawford St Ste 105
Portsmouth, VA 23704-2832

Mailing address

2145 Mystic Cove Dr
Virginia Beach, VA 23455-2961
Phone (757) 651-5922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190227002742 VA Practitioner - Chiropractic 8022357524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Church Point Chiropractic PCGroup PAC ID 3779506969, 4 clinicians

Practice addresses (Care Compare)

524 Independence Blvd
Virginia Beach, VA 23462-2221
Phone (757) 745-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104557450VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Spine & Wellness Center LLC Chiropractor CurrentSince Jan 7, 2019 Accepting new patients
Church Point Chiropractic, PC Chiropractor CurrentSince Apr 1, 2021 Accepting new patients

Locations

355 Crawford St
Ste 105
Portsmouth, VA 23704
Phone (757) 399-4700

1510 Breezeport Way
Ste 100
Suffolk, VA 23435
Phone (252) 347-5996

524 Independence Blvd
Virginia Beach, VA 23462
Phone (757) 460-2522

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514332800000",
    "number": "1295241396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 MYSTIC COVE DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234552961",
            "telephone_number": "757-651-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 CRAWFORD ST STE 105",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042832",
            "telephone_number": "757-399-4700",
            "fax_number": "757-399-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "ERIKA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-27",
        "last_updated": "2017-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.