Individual provider Active NPI

Steven L Lackie, P.A.

  • Medical Physician Assistant
  • Saginaw, MI
National Provider Identifier
1407895568
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001993 Issued in MI
Practice address
4677 Towne Centre Rd
Suite 301
Saginaw, MI 48604-2846
Phone
(989) 799-8712
Fax
(989) 791-4216
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001993 MI Primary

Addresses

Primary practice location

4677 Towne Centre Rd
Suite 301
Saginaw, MI 48604-2846

Mailing address

4677 Towne Centre Rd
Suite 301
Saginaw, MI 48604-2846
Phone (989) 799-8712

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001993MIMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407895568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4677 TOWNE CENTRE RD",
            "address_2": "SUITE 301",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042846",
            "telephone_number": "989-799-8712",
            "fax_number": "989-791-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4677 TOWNE CENTRE RD",
            "address_2": "SUITE 301",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042846",
            "telephone_number": "989-799-8712",
            "fax_number": "989-791-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKIE",
        "first_name": "STEVEN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "001993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.