Individual provider Active NPI

Lacey Palmer Conaway, ARNP

  • Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1629227608
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
38207 Issued in TN
Practice address
1374 Cordova CV
Germantown, TN 38138-2200
Phone
(602) 816-2938
NPI assigned
Sep 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 38207 TN Primary
Nurse Practitioner 363L00000X 902490 MS

Addresses

Primary practice location

1374 Cordova CV
Germantown, TN 38138-2200

Mailing address

1374 Cordova CV
Germantown, TN 38138-2200
Phone (602) 816-2938

Other identifiers 1

IdentifierTypeStateIssuer
200054500BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20220810000096 MS Practitioner - Nurse Practitioner 2264597327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horn Lake Family Practice IncGroup PAC ID 9537198213, 6 clinicians

Practice addresses (Care Compare)

3102 Goodman Rd W
Horn Lake, MS 38637-1172
Phone 6623426676222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38207TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Horn Lake Family Practice Inc CurrentSince Jul 25, 2022 Accepting new patients

Locations

3102 Goodman Rd W
Horn Lake, MS 38637
Phone (662) 342-6676

Organizations & group practices 1

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": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1629227608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1374 CORDOVA CV",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382200",
            "telephone_number": "602-816-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1374 CORDOVA CV",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382200",
            "telephone_number": "602-816-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONAWAY",
        "first_name": "LACEY",
        "middle_name": "PALMER",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "38207",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "902490",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200054500B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.