Active NPI
Robert Ray Lacey, O.D.
- Optometrist
- Aberdeen, MS
National Provider Identifier
1639198203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- MS403
- Practice address
- 207 W Commerce St
Aberdeen, MS 39730-2633 - Phone
- (662) 369-9020
- Fax
- (662) 369-9810
- NPI assigned
- Jul 18, 2006
- Last updated
- Aug 27, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | MS403 | MS | Primary |
Addresses
Primary practice location
207 W Commerce St
Aberdeen, MS 39730-2633
Mailing address
207 W Commerce St
Aberdeen, MS 39730-2633
Phone (662) 369-9020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00880116 | Medicaid | MS |
Other names 1
- Dr. Robert Ray Lacey
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MS403 | MS | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251331200000",
"number": "1639198203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 W COMMERCE ST",
"city": "ABERDEEN",
"state": "MS",
"postal_code": "397302633",
"telephone_number": "662-369-9020",
"fax_number": "662-369-9810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 W COMMERCE ST",
"city": "ABERDEEN",
"state": "MS",
"postal_code": "397302633",
"telephone_number": "662-369-9020",
"fax_number": "662-369-9810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACEY",
"first_name": "ROBERT",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2009-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MS",
"license": "MS403",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00880116",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ROBERT",
"last_name": "LACEY",
"middle_name": "RAY",
"prefix": "DR.",
"credential": "O.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Aberdeen, MS
- Hospice Advantage, LLC.
- China Johnson
- Amy B Joslin, AGACNP-BC
- Nina P Jurney, FNP
- Yusef Muhammed Kurdi, MD
- Lifebrite Hospital Group of Aberdeen LLC (Nina Jurney Family Medical)
- Lifebrite Hospital Group of Aberdeen LLC
- Lifebrite Hospital Group of Aberdeen LLC
- Lifebrite Hospital Group of Aberdeen LLC (Emergency Department)
- Lifebrite Hospital Group of Aberdeen LLC (LifeBrite Community Hospital of Aberdeen)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.