Active NPI
Lacy Dunn
- Physical Therapy Assistant
- Henderson, NC
National Provider Identifier
1467969113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A6253
- Practice address
- 2275 Ruin Creek Rd
Henderson, NC 27537-8732 - Phone
- (252) 492-0066
- NPI assigned
- Jan 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A6253 | NC | Primary |
Addresses
Primary practice location
2275 Ruin Creek Rd
Henderson, NC 27537-8732
Mailing address
5200 Summit Manor LN Apt 308
Raleigh, NC 27613-7069
Phone (252) 474-2019
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A6253 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514937600000",
"number": "1467969113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 SUMMIT MANOR LN APT 308",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276137069",
"telephone_number": "252-474-2019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2275 RUIN CREEK RD",
"city": "HENDERSON",
"state": "NC",
"postal_code": "275378732",
"telephone_number": "252-492-0066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNN",
"first_name": "LACY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-03",
"last_updated": "2018-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "A6253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.