Stacey Elizabeth Lacey

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP129484 Issued in SC

Practice address

300 Singleton Ridge Rd
Conway, SC 29526-9142

Phone

(843) 347-8175

Fax

(432) 346-7598

NPI assigned

Nov 6, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elacey32523@directmcleodehealth.org

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.

• McLeod Physician Associates II

  • Family Medicine Physician
  • Florence, SC
  • NPI 1801990494
  Medicare reassignment NPD
• McLeod Regional Medical Center of the Pee Dee, Inc

  dba Cbo MRMC Emergency

  • Emergency Medical Services (Emergency Medicine) Physician
  • Florence, SC
  • NPI 1154371433
  Medicare reassignment NPD
• McLeod Physician Associates II

  dba McLeod Psychiatric Associates

  • Psychiatry Physician
  • Darlington, SC
  • NPI 1629189766

  Adult Health

  NPD
• McLeod Physician Associates II

  dba McLeod Orthopaedics - Florence

  • Orthopaedic Surgery Physician
  • Florence, SC
  • NPI 1922555739
  NPD
• McLeod Regional Medical Center of the Pee Dee, Inc

  dba McLeod Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Florence, SC
  • NPI 1871775841
  NPD
• Cedar Park Health Systems LP

  dba Cedar Park Regional Medical Center Occupational Medicine Clinic

  • Occupational Medicine Physician
  • Cedar Park, TX
  • NPI 1720344500
  NPD (past)

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1679946008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MEDICAL PKWY",
            "address_2": "BLDG B, STE 205",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137763",
            "telephone_number": "512-528-7401",
            "fax_number": "512-528-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-347-8175",
            "fax_number": "432-346-7598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "148 Cypress Estates Dr",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295768698",
            "country_code": "US",
            "telephone_number": "512-774-7054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACEY",
        "first_name": "STACEY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-06",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "758324",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP129484",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "AP129484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KRT Enterprises (Medicine Mart Pharmacy)
• Raymond Leonard Krzyzaniak, M.D.
• Dhruva Kumbhani, AUD
• Jennifer O Kuperman, M.D.
• Paul M Kuperman, MD
• Jeffrey S Lackey, MD
• Kim Marie Lafler, BSN
• Lara Lagan, RN
• Emmett Michael Lampkin, MD
• Honey Valarie Lance

• Adult Health Nurse Practitioner in Conway, SC
• Providers in Conway, SC by specialty
• Adult Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.