Active NPI
Lacy Holland Lacey, AGACNP-BC
- Nurse Practitioner
- Marietta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN230232
- Practice address
- 677 Church St NE
Marietta, GA 30060-1101 - Phone
- (770) 422-2326
- Fax
- (770) 422-7797
- NPI assigned
- Sep 26, 2018
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN230232 | GA | Primary |
Addresses
Primary practice location
677 Church St NE
Marietta, GA 30060-1101
Mailing address
677 Church St NE
Marietta, GA 30060-1101
Phone (770) 422-2326
Other practice location 1
1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone (762) 235-2150
Other names 1
- Lacy Jeanette Holland
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lacy.lacey.1@1498.direct.athenahealth.com | ||
| Direct Messaging Address | llacey495169@directwellstar.org | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004
677 Church Nest
Marietta, GA 30060-1101
677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585
Hospital & facility affiliations
- Wellstar Kennestone Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients |
Locations
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435
805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616
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.
-
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Marietta, GA
- NPI 1649248626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1346725264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "677 CHURCH ST NE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601101",
"telephone_number": "770-422-2326",
"fax_number": "770-422-7797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "677 CHURCH ST NE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601101",
"telephone_number": "770-422-2326",
"fax_number": "770-422-7797"
}
],
"practiceLocations": [
{
"address_1": "1825 Martha Berry Blvd NW",
"address_purpose": "LOCATION",
"city": "Rome",
"state": "GA",
"postal_code": "301651625",
"country_code": "US",
"telephone_number": "762-235-2150",
"fax_number": "706-291-8380",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LACEY",
"first_name": "LACY",
"middle_name": "HOLLAND",
"credential": "AGACNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-26",
"last_updated": "2022-11-14",
"certification_date": "2022-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN230232",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lacy.lacey.1@1498.direct.athenahealth.com",
"affiliation": "N",
"address_1": "1825 Martha Berry Blvd NW",
"city": "Rome",
"state": "GA",
"country_code": "US",
"postal_code": "301651625",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "llacey495169@directwellstar.org",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "677 Church St NE",
"city": "Marietta",
"state": "GA",
"country_code": "US",
"postal_code": "300601101",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LACY",
"last_name": "HOLLAND",
"middle_name": "JEANETTE",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.
- 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.