Lacey Wickersham, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10026939 Issued in OR

Practice address

896 Fortner St
Ontario, OR 97914-1787

Phone

(541) 881-2828

NPI assigned

Jul 29, 2024

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 1

Medicare fee-for-service enrollment

Enrolled in OR, ID2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Yale University School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Family Health Care IncGroup PAC ID 0547169591, shared by 8 NPIs, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052
• St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwickersham736004@direct.ochin.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.

• Valley Family Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Ontario, OR
  • NPI 1295415032
  Medicare reassignment NPD
• Valley Family Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Payette, ID
  • NPI 1407886484
  Medicare reassignment NPD
• Valley Family Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Nyssa, OR
  • NPI 1083641310
  NPD
• Valley Family Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Emmett, ID
  • NPI 1932139995
  NPD
• Valley Family Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Ontario, OR
  • NPI 1992732291
  NPD (past)

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

• Saint Alphonsus Medical Center- Ontario Inc

  • General Acute Care Hospital
  • Ontario, OR
  • NPI 1891891792
  Care Compare affiliation
• St Lukes Regional Medical Center

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1710716824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 NE 10TH AVE",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836615420",
            "telephone_number": "541-881-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "896 FORTNER ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979141787",
            "telephone_number": "541-881-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKERSHAM",
        "first_name": "LACEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10026939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500844300",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bernt E White, D.M.D
• Caden White
• Richard R White, D.M.D.
• Rieneke D White, FNP-BC, CNM
• Jason Dennis Whittier
• Melissa Anne Wieland, LPC-ASSOCIATE
• Sharon Kaye Wiese
• Patrick Riley Wilcox, PMHNP-BC
• Jason M Wilhelmsen, MD
• Channa Rae Williams

• Family Nurse Practitioner in Ontario, OR
• Providers in Ontario, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.