Jaclyn Elizabeth Lackey, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00313100 Issued in NJ

Practice address

1910 Hwy 35
Oakhurst, NJ 07755-2715

Phone

(732) 531-4747

NPI assigned

Dec 17, 2010

Last updated

Mar 5, 2020By 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

Medicare fee-for-service enrollment

Enrolled in NJ, KS, IN, TN, MI, FL, KY, MD8 enrollments

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 8

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Spiras Health, Inc.

  • Family Nurse Practitioner
  • Brentwood, TN
  • NPI 1740885565

  FL, IN, KS, KY, MD, MI, NJ

  Medicare reassignment NPD
• Barnabas Health Medical Group, PC

  • Specialist
  • West Orange, NJ
  • NPI 1447206420
  NPD (past)
• Charles L. Spellman, DO

  • Internal Medicine Physician
  • W Long Branch, NJ
  • NPI 1619082922
  NPD (past)
• Hospital Medicine of Monmouth County

  • Hospitalist Physician
  • Long Branch, NJ
  • NPI 1578715389
  NPD (past)
• Monmouth Surgeons, LLC

  • Surgery Physician
  • Long Branch, NJ
  • NPI 1801931563
  NPD (past)
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospitals

  • Hospitalist Physician
  • Grand Rapids, MI
  • NPI 1558407189
  NPD (past)

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1497058168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 HWY 35",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "077552715",
            "telephone_number": "732-531-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 HWY 35",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "077552715",
            "telephone_number": "732-531-4747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 2nd Ave",
            "address_2": "Suite W217",
            "address_purpose": "LOCATION",
            "city": "Long Branch",
            "state": "NJ",
            "postal_code": "077406303",
            "country_code": "US",
            "telephone_number": "732-923-6696",
            "fax_number": "732-923-6626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "JACLYN",
        "middle_name": "ELIZABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-17",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00313100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kretov Medical Arts LLC
• Aleksey Kretov, MD
• Andrew Kruger, DO
• Denise Kubata, PHARMD
• Kathryn L Kumta, APN-BC
• Thomas Rosser Lake III, MD
• Lakewood Community Services Corp.
• Kris Roberte Laliberte, B.S.,D.C.
• Samantha Landi, LPC
• Andrea G Langan, CRNFA

• Family Nurse Practitioner in Oakhurst, NJ
• Providers in Oakhurst, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.