Individual provider Active NPI

Thomas Kevin Lackey

  • Anesthesiology Physician
  • Rainbow City, AL
National Provider Identifier
1720060247
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
21928 Issued in AL
Practice address
3804 Rainbow Dr
Rainbow City, AL 35906
Phone
(256) 952-2200
Fax
(256) 952-2202
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 21928 AL Primary

Addresses

Primary practice location

3804 Rainbow Dr
Rainbow City, AL 35906

Mailing address

3804 Rainbow Dr
Rainbow City, AL 35906-3051
Phone (256) 952-2200

Other identifiers 2

IdentifierTypeStateIssuer
051502368OtherALBLUE CROSS BLUE SHIELD
009960110MedicaidAL

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090528000530 AL Practitioner - AnesthesiologyPractitioner - Pain Management 3971652611 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of Alabama School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia AssociatesGroup PAC ID 3476570870, 60 clinicians
Blue Lake Health Alabama, LLCGroup PAC ID 8325415375, 39 clinicians

Practice addresses (Care Compare)

Gadsden, AL 35901
Phone (256) 546-5281

1 Commerce Square
Gadsden, AL 35901-5252

103 Helton CT
Florence, AL 35630-1464
Phone (205) 848-2925

400 E 10TH St
Anniston, AL 36207-4716
Phone (256) 546-5281

Hospital & facility affiliations

  • Northeast Alabama Regional Medical Center Hospital, Anniston, AL, CCN 010078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21928ALMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Epix Anesthesia of Alabama LLC Anesthesiology CurrentSince Aug 1, 2016 Accepting new patients
Hospitalist Medicine Physicians of Alabama-TCS Inc Anesthesiology CurrentSince Apr 1, 2022 Accepting new patients
Alabama Anesthesiology and Pain Consultants P.C. Anesthesiology CurrentSince Aug 1, 2020 Accepting new patients
Anesthesia Associates Anesthesiology CurrentSince Aug 1, 2021 Accepting new patients
Acsh Primary Care of Alabama, LLC Past Accepting new patients
Anniston Anesthesia PA Anesthesiology Past Accepting new patients

Locations

400 E 10th St
Anniston, AL 36207
Phone (256) 235-5121

2505 US Highway 431
Boaz, AL 35957
Phone (256) 506-0061

400 Northwood Dr
Centre, AL 35960
Phone (256) 927-1382

200 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-3150

1 Commerce Sq
Gadsden, AL 35901

8000 AL Highway 69
Guntersville, AL 35976
Phone (256) 571-8000

1440 Highway Dr
Oxford, AL 36203
Phone (256) 241-2230

2804 Hospital Dr
Pell City, AL 35125
Phone (205) 338-6655

3804 Rainbow Dr
Rainbow City, AL 35906
Phone (205) 338-6655

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Interoperability endpoints

  • Direct secure messaging: thomas.lackey@1801.securemail.prognocis.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1720060247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 RAINBOW DR",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359063051",
            "telephone_number": "256-952-2200",
            "fax_number": "256-952-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 RAINBOW DR",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "35906",
            "telephone_number": "256-952-2200",
            "fax_number": "256-952-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "THOMAS",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "21928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "051502368",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009960110",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rainbow City, AL

Sources for this page

Verify at the official NPI Registry.