Active NPI
Rachael Nichole Lacey, PT
- Physical Therapist
- Lagrange, GA
National Provider Identifier
1801407366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT014851
- Practice address
- 1805 Vernon Rd Ste a
Lagrange, GA 30240-3871 - Phone
- (706) 845-9383
- NPI assigned
- Aug 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT014851 | GA | Primary |
Addresses
Primary practice location
1805 Vernon Rd Ste a
Lagrange, GA 30240-3871
Mailing address
124 Walden Chase LN
Columbus, GA 31909-1762
Phone (843) 864-8360
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597017600000",
"number": "1801407366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 WALDEN CHASE LN",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319091762",
"telephone_number": "843-864-8360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1805 VERNON RD STE A",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302403871",
"telephone_number": "706-845-9383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACEY",
"first_name": "RACHAEL",
"middle_name": "NICHOLE",
"name_prefix": "Dr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-10",
"last_updated": "2020-08-10",
"certification_date": "2020-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT014851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.