Daniel James Lackey, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5010621 Issued in NC

Practice address

1287 Creekshire Way
Winston Salem, NC 27103-3057

Phone

(336) 245-9521

Fax

(855) 308-2340

NPI assigned

Jun 25, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Internal Medicine & Wellness Center PA

  • Ph.D. Medical Genetics
  • Charlotte, NC
  • NPI 1871558262
  NPD (past)
• Robinhood Integrative Health, PLLC

  • Primary Care Clinic/Center
  • Winston Salem, NC
  • NPI 1760771406
  NPD (past)

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1548755432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287790360",
            "telephone_number": "888-339-6065",
            "fax_number": "828-538-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 CREEKSHIRE WAY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033057",
            "telephone_number": "336-245-9521",
            "fax_number": "855-308-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "Q00092508",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548755432",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "19YVP",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NNG668A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Marcia Lacewell, PT, DPT
• Ashley Schaeffer Lacey, APRN
• Faisal Lachab, MD
• Karen L Lachapelle, MA., CCC-SLP
• Christopher Marcus Lack, M.D. PH.D.
• Haley Hendrix Lackey, M.S. CCC-SLP
• Justin Trevor Lackey, MD
• Philip Lackey, MD
• Victoria Donovan Lackey, M.D.
• Sandra Lacoma, P.T.

• Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.