James Manning Lackey, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L5014 Issued in TX

Practice address

2235 Thousand Oaks Dr
Suite #117
San Antonio, TX 78232-3966

Phone

(210) 490-1000

Fax

(210) 496-3590

NPI assigned

Nov 28, 2006

Last updated

Nov 1, 2012By the provider in NPPES

Sex

Male

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 5

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Texas Southwestern Medical School at Dallas, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prophylaxis Healthcare LLCGroup PAC ID 3072784289, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillcrest Hospital Pryor Hospital, Pryor, OK, CCN 370015

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Prophylaxis Healthcare LLC

  dba Axis HealthCare

  • Multi-Specialty Clinic/Center
  • Bixby, OK
  • NPI 1538453923

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Saint Raphael Family Focused Medicine PA

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1447430608
  NPD (past) Authorized official
• Prophylaxis Healthcare LLC

  dba Axis Behavioral Health

  • Community/Behavioral Health Agency
  • Bixby, OK
  • NPI 1285438317
  NPD
• Alamo City Medical Group, PLLC

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1558354092
  NPD (past)
• Riverwalk Clinic, LLC

  dba Alamo City Medical Group

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1629191176

  Family Medicine

  NPD (past)
• Optimum Laboratory Services, LLC

  • Clinical Medical Laboratory
  • Sapulpa, OK
  • NPI 1922492081
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

• Ahs Pryor Hospital, LLC

  dba Hillcrest Hospital Pryor

  • General Acute Care Hospital
  • Pryor, OK
  • NPI 1780125005
  Care Compare affiliation

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1730255050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 CENTRAL PARKWAY NORTH",
            "address_2": "SUITE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782325024",
            "telephone_number": "210-541-4500",
            "fax_number": "210-541-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 THOUSAND OAKS DR",
            "address_2": "SUITE #117",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323966",
            "telephone_number": "210-490-1000",
            "fax_number": "210-496-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "JAMES",
        "middle_name": "MANNING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L5014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216649802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "8CJ355",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216649801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN NUMBER",
            "identifier": "Y29190",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE NUMBER",
            "identifier": "L5014",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcela Raquel Lacayo Espinoza, DDS
• Andrea Lacerda
• Lacey L. Aguero
• Tracy Ann Lachance-Funes, HIS
• Kathy Ann Lacivita, MD
• Jennifer Joy Lacoss, M.D.
• Cody P Lacoste
• Brandon Lacour
• Lacuna Autism Services LLC
• Aeris M Lacy, LVN

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.