NPIMap

Individual provider Active NPI

Lacy J Holley

  • Nurse Practitioner
  • Hot Springs, AR
National Provider Identifier
1447893987
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
121708 Issued in AR
Practice address
1662 Higdon Ferry Rd Ste 200
Hot Springs, AR 71913-6981
Phone
(501) 623-2781
Fax
(501) 623-1774
NPI assigned
Oct 28, 2019
Last updated
Jul 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 121708 AR Primary
Family Nurse Practitioner 363LF0000X 121708 AR

Addresses

Primary practice location

1662 Higdon Ferry Rd Ste 200
Hot Springs, AR 71913-6981

Mailing address

PO Box 21850
Hot Springs, AR 71903-1850
Phone (314) 364-7595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191115001311 AR Practitioner - Nurse Practitioner 5193157949 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revive Health and WellnessGroup PAC ID 1759726060, 4 clinicians

Practice addresses (Care Compare)

1636 Higdon Ferry Rd
Hot Springs, AR 71913-6912
Phone (501) 229-3368

411 Woodland CV
Malvern, AR 72104-4864

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
121708ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Health and Wellness Family CurrentSince Jun 4, 2025 Accepting new patients
First Docs LLC CurrentSince Jul 9, 2023 Accepting new patients
LJ Health & Wellness LLC Family CurrentSince Jan 1, 2024 Accepting new patients
Shawn Purifoy, M.D., P.a. CurrentSince Jul 12, 2021 Accepting new patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Aug 1, 2021 Accepting new patients
Hot Springs MRI Center Past Accepting new patients
Mercer Bucks Medical Associates, P.C. Past Accepting new patients

Locations

1 Medical Park Dr
Bryant, AR 72015
Phone (501) 776-6000

1636 Higdon Ferry Rd
#301
Hot Springs, AR 71913

1636 Higdon Ferry Rd
Hot Springs National Park, AR 71913
Phone (501) 520-2000

1910 Malvern Ave
Hot Springs National Park, AR 71901
Phone (501) 321-1000

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1517 S Main St
Malvern, AR 72104
Phone (501) 332-7525

850 Henry St
Malvern, AR 72104
Phone (501) 332-5245

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

Interoperability endpoints

  • Direct secure messaging: lholley284626@directb.mercy.net

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1447893987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21850",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719031850",
            "telephone_number": "314-364-7595",
            "fax_number": "501-321-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1662 HIGDON FERRY RD STE 200",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136981",
            "telephone_number": "501-623-2781",
            "fax_number": "501-623-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "LACY",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "121708",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "121708",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

Verify at the official NPI Registry.