Active NPI
Gayna Georgette Lacy, DPT
- Physical Therapist
- Laurel, MD
National Provider Identifier
1639370091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22170
- Practice address
- 13946 Baltimore Ave
Laurel, MD 20707-5000 - Phone
- (301) 498-2212
- Fax
- (301) 498-2213
- NPI assigned
- May 31, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 22170 | MD | Primary |
Addresses
Primary practice location
13946 Baltimore Ave
Laurel, MD 20707-5000
Mailing address
PO Box 4058
Crofton, MD 21114-4058
Phone (410) 315-9080
Other practice location 1
8312 Lyndhurst St
Laurel, MD 20724-7902
Phone (202) 321-7008
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F8710017 | Other | DC | CAREFIRST BLUE CROSS BLUE SHIELD |
| 22170 | Other | MD | PT LICENSE |
Other names 1
- Gayna Thomas Lacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Sportscare & Rehab Associates, LLC | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Annapolis, MD
- NPI 1396122842
-
- Physical Therapist
- College Park, MD
- NPI 1902911233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562112000000",
"number": "1639370091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4058",
"city": "CROFTON",
"state": "MD",
"postal_code": "211144058",
"telephone_number": "410-315-9080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13946 BALTIMORE AVE",
"city": "LAUREL",
"state": "MD",
"postal_code": "207075000",
"telephone_number": "301-498-2212",
"fax_number": "301-498-2213"
}
],
"practiceLocations": [
{
"address_1": "8312 Lyndhurst St",
"address_purpose": "LOCATION",
"city": "Laurel",
"state": "MD",
"postal_code": "207247902",
"country_code": "US",
"telephone_number": "202-321-7008",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LACY",
"first_name": "GAYNA",
"middle_name": "GEORGETTE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-31",
"last_updated": "2019-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "22170",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BLUE CROSS BLUE SHIELD",
"identifier": "F8710017",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "22170",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GAYNA",
"last_name": "LACY",
"middle_name": "THOMAS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.