Logan B Lackey II, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

2016020760 Issued in MO

Practice address

2055 S Fremont Ave
Suite 120
Springfield, MO 65804-2206

Phone

(417) 820-2500

NPI assigned

Apr 20, 2010

Last updated

Jul 5, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Northeastern Ohio University College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialists in Medical Imaging SCGroup PAC ID 2163733544, 228 clinicians

Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, shared by 14 NPIs, 385 clinicians

Breast Imaging of the Ozarks LLCGroup PAC ID 0244600146, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blessing Hospital Hospital, Quincy, IL, CCN 140015
• Illini Community Hospital Hospital, Pittsfield, IL, CCN 141315
• Freeman Neosho Hospital Hospital, Neosho, MO, CCN 261331

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

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.

• Breast Imaging of the Ozarks LLC

  • Diagnostic Radiology Physician
  • Springfield, MO
  • NPI 1417600412
  Medicare reassignment Care Compare group NPD Authorized official
• Blessing Hospital

  • Multi-Specialty Clinic/Center
  • Quincy, IL
  • NPI 1114471737

  MO

  Medicare reassignment Care Compare group NPD
• Specialists in Medical Imaging SC

  • Diagnostic Radiology Physician
  • Olympia Fields, IL
  • NPI 1841687951

  MO

  Medicare reassignment Care Compare group NPD
• Freeman-Oak Hill Health System

  dba Freeman Physician Group

  • Multi-Specialty Clinic/Center
  • Joplin, MO
  • NPI 1679517023
  Medicare reassignment NPD
• Freeman-Oak Hill Health System

  dba Freeman Health System

  • General Acute Care Hospital
  • Joplin, MO
  • NPI 1891809679
  Medicare reassignment NPD
• Miracl, LLC

  • Multi-Specialty Clinic/Center
  • Rolla, MO
  • NPI 1205304300
  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475

  Diagnostic Radiology

  Medicare reassignment NPD
• Blessing Hospital

  dba Blessing Health Monroe City

  • Rural Health Clinic/Center
  • Monroe City, MO
  • NPI 1013683507
  NPD

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

• Freeman Neosho Hospital

  • Critical Access Hospital
  • Neosho, MO
  • NPI 1598873796
  Care Compare affiliation
• Blessing Hospital

  • Nurse Practitioner
  • Quincy, IL
  • NPI 1417204827

  Hospital

  Care Compare affiliation
• Blessing Hospital

  • General Acute Care Hospital
  • Quincy, IL
  • NPI 1760571699
  Care Compare affiliation
• Blessingcare Corporation

  dba Illini Community Hospital

  • Critical Access Hospital
  • Pittsfield, IL
  • NPI 1720086218
  Care Compare affiliation

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1740506419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 S FREMONT AVE",
            "address_2": "SUITE 120",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042206",
            "telephone_number": "417-820-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 S FREMONT AVE",
            "address_2": "SUITE 120",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042206",
            "telephone_number": "417-820-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "LOGAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-20",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2016020760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlea Mickelle Lacey, NP
• McKenna Joanne Lacey
• Sarah M Lachance
• Frank Lack, LMT
• Elizabeth Grace Lackey
• Patrick Ladapo
• Keith A Laferriere, MD
• Anna Marie Laffoon, RD
• Jayaprabha Vijaykumar Lafontaine, MD
• Sarai I Lajas, LPC

• Diagnostic Radiology Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.