Individual provider Active NPI

Lacey Jackson Teer

  • Hearing Instrument Specialist
  • Texarkana, TX
National Provider Identifier
1386958981
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
80404 Issued in TX
Practice address
4214 Texas Blvd
Texarkana, TX 75503-3013
Phone
(903) 793-0691
Fax
(903) 794-2046
NPI assigned
Aug 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 80404 TX Primary

Addresses

Primary practice location

4214 Texas Blvd
Texarkana, TX 75503-3013

Mailing address

4214 Texas Blvd
Texarkana, TX 75503-3013
Phone (903) 793-0691

Other identifiers 1

IdentifierTypeStateIssuer
80404OtherTXSTATE COMMISSION OF EXAMINERS FITTING & DISPENSING HEARING AIDS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1386958981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 TEXAS BLVD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033013",
            "telephone_number": "903-793-0691",
            "fax_number": "903-794-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 TEXAS BLVD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033013",
            "telephone_number": "903-793-0691",
            "fax_number": "903-794-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON TEER",
        "first_name": "LACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-06",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "TX",
            "license": "80404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE COMMISSION OF EXAMINERS FITTING & DISPENSING HEARING AIDS",
            "identifier": "80404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.