Lacey Caroline Gardner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005080 Issued in MI

Practice address

1970 Ashland Dr
Mount Pleasant, MI 48858-1203

Phone

(989) 779-5262

Fax

(989) 772-6784

NPI assigned

Jan 2, 2008

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 identifiers 6

Medicare fee-for-service enrollment

Enrolled in MI

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

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: lacey.gardner.p1@direct.isabellahealth.nextgenshare.com

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.

• Isabella Citizens for Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mt Pleasant, MI
  • NPI 1104177195
  Medicare reassignment NPD (past)
• Degara App, PLLC

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1265976971
  Medicare reassignment
• Emergency Department Physicians, P.C.

  • Emergency Medicine Physician
  • Detroit, MI
  • NPI 1225083595
  Medicare reassignment
• Isabella Citizens for Health Inc

  • Family Medicine Physician
  • Mt Pleasant, MI
  • NPI 1245610302
  NPD
• Isabella Citizens for Health Inc

  • Community/Retail Pharmacy
  • Mt Pleasant, MI
  • NPI 1942842471
  NPD
• Euclid Medical Group PC

  • Family Medicine Physician
  • Bay City, MI
  • NPI 1366488728
  NPD (past)

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1679758254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 ASHLAND DR",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488581203",
            "telephone_number": "989-779-5262",
            "fax_number": "989-772-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ASHLAND DR",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488581203",
            "telephone_number": "989-779-5262",
            "fax_number": "989-772-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "LACEY",
        "middle_name": "CAROLINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "010Z960170",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "MI1118",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "080B610040",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "0P43930",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "0Z96017",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0Z96017",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Eve Gamache
• Kyle David Gandy, PA
• Crystal Kay Gange
• Carrie Garchow, PA
• Brandi Garcia
• Stacy L Garner, PHARMD
• Charles Jesse Garrett II
• Gastroenterology Hepatology and Endoscopy PLLC
• David Gates, LLPC
• Carrie Gaudard, DPT

• Physician Assistant in Mount Pleasant, MI
• Providers in Mount Pleasant, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.