Lacey Blakeney, NP-C
Individual provider Active NPI Family Nurse Practitioner · Laurel, MS
NPI 1326457151 · NPPES record last updated Apr 1, 2024
Key facts
- NPI
- 1326457151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R872620 (MS)
- Practice address
- 1002 Jefferson Street
Suite 450
Laurel, MS 39440-4327 - Phone
- (601) 428-0438
- NPI assigned
- Aug 6, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 28
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- South Central Clinics, Inc
Covington County Hospital
Practice addresses (Care Compare)
1002 Jefferson St
Laurel, MS 39440-4306
104 W Main St
20 Family Care Seminary
Seminary, MS 39479-9027
Phone (601) 722-3610
1203 Ave B
Ellisville, MS 39437-2080
Phone (601) 477-2226
1410 Jefferson St
Laurel, MS 39440-4243
Phone (601) 425-7522
1420 Jefferson St
Laurel, MS 39440-4243
Phone (601) 649-6823
1430 Jefferson St
Laurel, MS 39440-4243
Phone (601) 425-2273
1440 Jefferson St
Laurel, MS 39440-4243
Phone (601) 649-6213
3275 Hwy 49 E
Family Care Express
Collins, MS 39428-3776
Phone (601) 765-6292
603 S Main St
Green Tree Family Medical Clinic
Mt Olive, MS 39119-8902
Phone (601) 797-3405
Hospital & facility affiliations
- South Central Reg Med Ctr
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150316000467 | MS | Practitioner - Nurse Practitioner | 7214254010 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R872620 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covington County Hospital | Current |
Accepting new patients | |
| South Central Clinics, Inc | Current |
Accepting new patients | |
| South Central Clinics, Inc | Current | Accepting new patients | |
| Covington County Hospital | Current |
Accepting new patients | |
| Covington County Hospital | Current |
Accepting new patients | |
| South Central Clinics, Inc, | Current |
Accepting new patients | |
| Covington County Hospital | Current |
Accepting new patients | |
| Green Tree Family Medical Clinic | Current | Accepting new patients | |
| Southern Women'S Health, PLLC | Current |
Accepting new patients | |
| Southern Women'S Health, PLLC | Current |
Accepting new patients | |
| South Central Clinics, Inc | Current |
Accepting new patients | |
| Covington County Hospital | Current | Accepting new patients | |
| South Central Clinics, Inc. | Past | Accepting new patients | |
| Paki Inc | Past | Accepting new patients |
Locations
3275 Highway 49
Ste E
Collins, MS 39428
Phone (601) 765-6292
1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553
1242 Highway 29 N
Ellisville, MS 39437
Phone (601) 268-9393
6524 U S Highway 98
Hattiesburg, MS 39402
Phone (601) 268-9393
Interoperability endpoints
- https://api.platform.athenahealth.com/22789/brand/1/csg/1/fhir/r4
- lacey.blakeney@direct.scrmc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R872620 | MS | Yes |
Addresses
Primary practice location
1002 Jefferson Street
Suite 450
Laurel, MS 39440-4327
Mailing address
39 Franklin Rd Ste 300
Hattiesburg, MS 39402-1588
Phone (601) 268-9393
Other providers in Laurel, MS
- David S Black
- Blackwell Nursing Services LLC
- Dorita Jane Blair
- Thomas Harold Blake Jr.
- Danielle D. Blakeney
- Ramsi D Blankenship
- Blue Dot Medical, LLC
- Robia S Bobbett
- Laura Boleware
- Lisa K Bond
All providers in Laurel, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.