Lacy Gibbon, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

117838 Issued in OK

Practice address

949 E Taft Ave
Sapulpa, OK 74066-5728

Phone

(918) 224-6079

Fax

(918) 224-6126

NPI assigned

Jul 28, 2020

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

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Oklahoma Ambulatory Services LLCGroup PAC ID 9830447036, 43 clinicians

Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lgibbon552765@direct-ehr-ssmhc.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.

• Mercy Oklahoma Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Moore, OK
  • NPI 1922509173
  Medicare reassignment Care Compare group NPD
• Saints Medical Group, LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1437195922
  Medicare reassignment Care Compare group NPD
• Saints Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Edmond, OK
  • NPI 1730907700
  NPD

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

• SSM Health Care of Oklahoma Inc

  • Community/Retail Pharmacy
  • Oklahoma City, OK
  • NPI 1649602293

  Hospital

  Care Compare affiliation
• SSM Health Care of Oklahoma, Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1366545311
  Care Compare affiliation

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1699384438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 CEDAR LAKE BLVD STE 120",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147806",
            "telephone_number": "405-445-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 E TAFT AVE",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740665728",
            "telephone_number": "918-224-6079",
            "fax_number": "918-224-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBON",
        "first_name": "LACY",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "117838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Gebetsberger, M.D.
• Jeff George
• Georgia'S Christian Counseling
• Larry Douglas Gerken
• Ashley Gerrits
• Sherri Lynn Gibson, LPN
• Shannon Lea Gilbert
• Jennifer Gilpin
• Kelsey Girty
• Kelsey Joy Glazier, PA

• Family Nurse Practitioner in Sapulpa, OK
• Providers in Sapulpa, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.
• 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.