Lacey Tackett

Primary specialty

MidwifeTaxonomy code 176B00000X

License

LM226 Issued in AZ

Practice address

342 E Windy Way
Payson, AZ 85541-2174

Phone

(928) 951-6410

NPI assigned

Dec 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Creekside Birth Cottage

  • Midwife
  • Payson, AZ
  • NPI 1679350698
  NPD Authorized official

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1346887494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 E WINDY WAY",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855412174",
            "telephone_number": "928-951-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 E WINDY WAY",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855412174",
            "telephone_number": "928-951-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "LACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "AZ",
            "license": "LM226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "payson",
            "affiliation": "N",
            "address_1": "342 E Windy Way",
            "city": "Payson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "855412174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Donna S. Steckal, PH.D.
• Marjorie J Strickland, MHR
• Clinton Brent Stuart, DDS
• Elizabeth Ann Summers, D.C.
• Linda Ann Swartwood, RN
• Roberta Tantimonaco
• Tara Gann DNP
• Ashley Lynn Teets, DPT, PT, ATC, AT
• Tenney Rehab
• Jared Tenney, PT, MPT

• Midwife in Payson, AZ
• Providers in Payson, AZ by specialty
• Midwife in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.