Active NPI
Robert Boyd Morrison Lackey, MD
- Family Medicine Physician
- Dallastown, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD062802L
- Practice address
- 755 S Pleasant Ave
Dallastown, PA 17313-9252 - Phone
- (717) 851-1300
- Fax
- (717) 851-1310
- NPI assigned
- Jul 5, 2006
- Last updated
- Jul 20, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD062802L | PA | Primary |
Addresses
Primary practice location
755 S Pleasant Ave
Dallastown, PA 17313-9252
Mailing address
3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-1300
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 257467 | Other | PA | MAMSI-WMG |
| 80964 | Other | PA | UNISON-WMG |
| P002837 | Other | PA | GATEWAY-WMG |
| 7770327 | Other | PA | AETNA |
| 001707532 | Medicaid | PA | |
| 01069402 | Other | PA | CAPITAL BLUE CROSS-WMG |
| 1142374 | Other | PA | AMERIHEALTH MERCY-WMG |
| 034591 | Other | PA | JOHNS HOPKINS |
| 603586 | Other | MD | CAREFIRST MD BCBS |
| 278422 | Other | PA | HIGHMARK BLUE SHIELD |
| 78910 | Other | PA | GEISINGER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD062802L | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspan Medical Group | Family Medicine | Current | Accepting new patients |
| Wellspan Medical Group | Current | Accepting new patients | |
| Wellspan Medical Group | Current | Accepting new patients |
Locations
755 S Pleasant Ave
Dallastown, PA 17313
Phone (717) 851-1300
1803 Mount Rose Ave
Ste B3
York, PA 17403
Phone (717) 851-6816
1600 S George St
York, PA 17403
Phone (717) 848-3615
3421 Concord Rd
York, PA 17402
Phone (717) 851-2441
25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba WellSpan Digestive Health
- Gastroenterology Physician
- York, PA
- NPI 1669770004
-
dba WellSpan Pediatric Surgical Specialist
- Pediatric Surgery Physician
- York, PA
- NPI 1104799428
-
dba WellSpan Urgent Care
- Urgent Care Clinic/Center
- Waynesboro, PA
- NPI 1851097380
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468972800000",
"number": "1538190004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 CONCORD RD",
"city": "YORK",
"state": "PA",
"postal_code": "174029001",
"telephone_number": "717-851-1300",
"fax_number": "717-851-1310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 S PLEASANT AVE",
"city": "DALLASTOWN",
"state": "PA",
"postal_code": "173139252",
"telephone_number": "717-851-1300",
"fax_number": "717-851-1310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACKEY",
"first_name": "ROBERT",
"middle_name": "BOYD MORRISON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2016-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD062802L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI-WMG",
"identifier": "257467",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON-WMG",
"identifier": "80964",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY-WMG",
"identifier": "P002837",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7770327",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001707532",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS-WMG",
"identifier": "01069402",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY-WMG",
"identifier": "1142374",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHNS HOPKINS",
"identifier": "034591",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST MD BCBS",
"identifier": "603586",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "278422",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER",
"identifier": "78910",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dallastown, PA
- Kimberly Juntarashine
- Justina Healthcare, Inc
- Keystone State Family Chiropractic, LLC
- Dale L Kresge, M.D.
- Barbara Elaine Kruth, P.A.-C
- William Walter Lamison, PA-C
- Laurino Family Chiropractic,LLC (Richard A. Laurino DC)
- Richard Andrew Laurino, D.C.
- E. Riggs Leach III, D.D.S.
- Michele Louise Leader, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.