Lacey Leann Walk, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0406010739 Issued in IL

Practice address

10 Lincoln Hwy Ste 101
Fairview Heights, IL 62208-2100

Phone

(618) 624-0222

Fax

(618) 624-4930

NPI assigned

Sep 12, 2013

Last updated

Mar 21, 2017By 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

Other names 1

• Lacey Feezel Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marion Eye Centers LTDGroup PAC ID 3072426774, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: laceywalk@direct.eyecare-partners.com

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.

• Marion Eye Centers LTD.

  • Ophthalmology Physician
  • Marion, IL
  • NPI 1508865643
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1811322522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15933 CLAYTON RD",
            "address_2": "SUITE 201",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112172",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LINCOLN HWY STE 101",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082100",
            "telephone_number": "618-624-0222",
            "fax_number": "618-624-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALK",
        "first_name": "LACEY",
        "middle_name": "LEANN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "0406010739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "FEEZEL",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vitas Healthcare Corporation Midwest
• Brittney Sue Voyda, FNP
• Bailey Elizabeth Wahlquist, MA
• Walgreen Co (Walgreens #04832)
• Walgreens
• Brad Afton Walker, BS, LPTA
• Lora L. Walker
• Benjamin Z Wallace
• Raven Ward
• Kathrine Warring, OTRL

• Optometrist in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.