Lacey Kathleen Thompson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

125 Crestview Park Dr Ste 2
Dickson, TN 37055-2853

Phone

(615) 446-1370

Fax

(615) 560-5998

NPI assigned

Jul 23, 2017

Last updated

Oct 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mrs. Lacey Proctor Other name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dickson Medical Associates, PCGroup PAC ID 3971408774, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lthompson26968@dicksonmedicalassociates.gardenplot.direct-ci.com

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.

• Dickson Medical Associates PC

  • Family Medicine Physician
  • Dickson, TN
  • NPI 1568464873
  Medicare reassignment NPD (past)
• Dickson Medical Associates, PC

  dba DMA-South

  • Family Medicine Physician
  • Dickson, TN
  • NPI 1972606218
  Care Compare group NPD
• Dickson Medical Associates, PC

  dba DMA General Surgery & Endoscopy Center

  • Surgery Physician
  • Dickson, TN
  • NPI 1689777922
  NPD (past)
• Hospital Based Medical Services of Tennessee-I PC

  • Emergency Medicine Physician
  • Mount Juliet, TN
  • NPI 1225518285

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1366965287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR STE 209",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552856",
            "telephone_number": "615-441-4478",
            "fax_number": "615-446-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CRESTVIEW PARK DR STE 2",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552853",
            "telephone_number": "615-446-1370",
            "fax_number": "615-560-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LACEY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-23",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL LICENSE",
            "identifier": "PA-1566",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "PA3412",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "PROCTOR",
            "prefix": "MRS.",
            "credential": "PA-S",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tennessee Orthopaedic Alliance PA
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• Angela Terry
• The Care Giving Elite, LLC
• Amanda Rae Thomas, COTL
• Robert Thuan, MD
• Alexis Sierra Tidwell
• Jerry Neil Tidwell, OD
• Matthew Roach Tincher, M.D.
• Chessnee Renee Tinsley, APRN, FNP-C

• Physician Assistant in Dickson, TN
• Providers in Dickson, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.

Verify at the official NPI Registry.