Individual provider Active NPI

Lacy G Reynolds, APRN

  • Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1598233298
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
88134 Issued in OK
Practice address
1120 S Utica Ave
Tulsa, OK 74104-4012
Phone
(918) 579-1000
NPI assigned
Nov 12, 2018
Last updated
Nov 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 88134 OK Primary

Addresses

Primary practice location

1120 S Utica Ave
Tulsa, OK 74104-4012

Mailing address

821 W Waco St
Broken Arrow, OK 74011-2818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20190213002559 OK Practitioner - Nurse Practitioner 9537407721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tni-Kso PCGroup PAC ID 2062464399, 20 clinicians

Practice addresses (Care Compare)

1145 S Utica Ave
Suite 364
Tulsa, OK 74104-4004
Phone 9187125000144

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tni-Kso PC CurrentSince Jul 2, 2023 Accepting new patients
James R Webb Jr MD PC CurrentSince Aug 26, 2021 Accepting new patients

Locations

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

1145 S Utica Ave
Ste 364
Tulsa, OK 74104
Phone (918) 496-5195

6465 S Yale Ave
Ste 507
Tulsa, OK 74136
Phone (918) 481-2760

6550 E 71st St
Ste 200
Tulsa, OK 74133
Phone (918) 260-9322

8801 S 101st East Ave
Tulsa, OK 74133
Phone (800) 965-4565

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: lacy.g.reynolds@direct.davitaphysiciansolutions.com
  • Direct secure messaging: lreynolds137893@ahs.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1598233298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 W WACO ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740112818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044012",
            "telephone_number": "918-579-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "LACY",
        "middle_name": "G",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "88134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.