Lacey Katelyn Lackey, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT011462 Issued in GA

Practice address

429 Loganville Hwy Ste 110
Winder, GA 30680-5630

Phone

(770) 318-8030

Fax

(770) 318-8031

NPI assigned

Jul 2, 2014

Last updated

Nov 15, 2019By the provider in NPPES

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 GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlanta Rehabilitation and Performance CenterGroup PAC ID 5890692917, 95 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Atlanta Rehabilitation and Performance Center

  dba nMotion Physical Therapy

  • Physical Therapy Clinic/Center
  • Cleveland, GA
  • NPI 1982797494
  Medicare reassignment Care Compare group NPD
• Atlanta Rehabilitation and Performance Center

  • Physical Therapy Clinic/Center
  • Lawrenceville, GA
  • NPI 1013789205
  NPD

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1780090506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 WISTERIA DR",
            "address_2": "SUITE A",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782689",
            "telephone_number": "770-982-0102",
            "fax_number": "770-982-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 LOGANVILLE HWY STE 110",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306805630",
            "telephone_number": "770-318-8030",
            "fax_number": "770-318-8031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1735 Buford Hwy",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300411266",
            "country_code": "US",
            "telephone_number": "770-887-0502",
            "fax_number": "770-887-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "LACEY",
        "middle_name": "KATELYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Karl Krantz, RN
• Olga Kukharchuk, FNP-C
• Elena E. Kurz, DMD
• Stephanie Kutchback, NP
• Laboratory South Inc
• Sierra Larkin
• Michael Latella
• Danielle Lazenby
• Traci Reid Leak, MS, CCC,SLP
• Hyun Min Lee, PHARMD

• Physical Therapist in Winder, GA
• Providers in Winder, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.