Lacey McCrary

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

89833 Issued in OK

Practice address

2307 Gordon Cooper Dr
Shawnee, OK 74801-9007

Phone

(405) 273-5236

Fax

(405) 818-4690

NPI assigned

Jun 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lacey Hurd Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1669769477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748019007",
            "telephone_number": "405-273-5236",
            "fax_number": "405-818-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748019007",
            "telephone_number": "405-273-5236",
            "fax_number": "405-818-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRARY",
        "first_name": "LACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OK",
            "license": "89833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "HURD",
            "credential": "APRN-CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steilee McClain
• Grant Lee McClune, MD
• Addison Faith McColl
• Carole Elizabeth McCorkle, APRN, CNP, FNP-C
• Julie McCoy
• Rodney O McCrory, D.O.
• Cassidy Renee McCullough, OTR/L
• Garrett McDaniel
• Kristina Leighann McDonald, IBCLC
• Tamara Karen McDonough

• Primary Care Nurse Practitioner in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Primary Care Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.