Individual provider Active NPI

John W Lacey, M.D.

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1508964487
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD0000008513 Issued in TN
Practice address
1940 Alcoa Hwy
E180
Knoxville, TN 37920-2244
Phone
(865) 305-6810
Fax
(865) 305-6803
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD0000008513 TN Primary

Addresses

Primary practice location

1940 Alcoa Hwy
E180
Knoxville, TN 37920-2244

Mailing address

PO Box 440248
Nashville, TN 37244-0248
Phone (865) 670-6199

Other identifiers 1

IdentifierTypeStateIssuer
3163298MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110308000074 TN Practitioner - Internal Medicine 3375454457 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000008513TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Health System, Inc Internal Medicine Current Accepting new patients
University Health System, Inc Internal Medicine CurrentSince Feb 1, 2002 Accepting new patients
University Health System Inc CurrentSince Feb 1, 2002 Accepting new patients

Locations

1928 Alcoa Hwy
Ste 560
Knoxville, TN 37920
Phone (865) 544-6500

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

9625 Kroger Park Dr
Ste 300
Knoxville, TN 37922
Phone (865) 539-2287

1940 Alcoa Hwy
Ste E180
Knoxville, TN 37920
Phone (865) 305-6810

1928 Alcoa Hwy
Ste 118
Knoxville, TN 37920
Phone (865) 305-8787

1932 Alcoa Hwy
Ste 560
Knoxville, TN 37920
Phone (865) 544-6500

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

1932 Alcoa Hwy
Ste 570
Knoxville, TN 37920
Phone (865) 305-6500

1924 Alcoa Hwy
#56
Knoxville, TN 37920
Phone (865) 305-9081

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1508964487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440248",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372440248",
            "telephone_number": "865-670-6199",
            "fax_number": "865-670-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 ALCOA HWY",
            "address_2": "E180",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379202244",
            "telephone_number": "865-305-6810",
            "fax_number": "865-305-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEY",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000008513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3163298",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.