Ashley Coby Lackey, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-122189 Issued in AL

Practice address

19707 US Highway 280 E
Apt 1309
Smiths Station, AL 36877-4031

Phone

(256) 572-5936

NPI assigned

Feb 27, 2012

Last updated

May 19, 2022By the provider in NPPES

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

• Ashley Coby Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

University of Alabama School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Magnolia Medical LLCGroup PAC ID 9931508439, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Vincents Blount Hospital, Oneonta, AL, CCN 011305

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Magnolia Medical LLC

  dba United Doctors Family Medical Center Sand Rock

  • Family Medicine Physician
  • Sandrock, AL
  • NPI 1851976054

  5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Magnolia Medical LLC

  dba United Doctors Family Medical Center Sand Rock

  • Family Medicine Physician
  • Sandrock, AL
  • NPI 1851976054
  Medicare reassignment Care Compare group NPD
• Gana Holdings, LLC

  dba United Doctors Family Medical Center - Snead

  • Internal Medicine Physician
  • Snead, AL
  • NPI 1396375267
  Medicare reassignment NPD
• United Doctors Family Medical Center LLC

  • Internal Medicine Physician
  • Boaz, AL
  • NPI 1013313709
  Medicare reassignment NPD
• Qofl Services LLC

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1942554837
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Vincents Blount

  • Critical Access Hospital
  • Oneonta, AL
  • NPI 1184967523
  Care Compare affiliation

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1679847487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2986 US HIGHWAY 431",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575848",
            "telephone_number": "256-572-5936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19707 US HIGHWAY 280 E",
            "address_2": "APT 1309",
            "city": "SMITHS STATION",
            "state": "AL",
            "postal_code": "368774031",
            "telephone_number": "256-572-5936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "ASHLEY",
        "middle_name": "COBY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-27",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-122189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "COBY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Jessica Leigh Hutzul, ATC, LAT, MED
• Samantha Lawson, DO
• Crystal V Lewis, ED.S., LPC
• LL Home Health & Homemaker Service (Peace At Home Healthcare & Homemaker Service)
• Vernice J Maiga
• Majestic Seasons, LLC

• Nurse Practitioner in Smiths Station, AL
• Providers in Smiths Station, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.