Lacey McRoy, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13273 Issued in WI

Practice address

1160 Kepler Dr
Green Bay, WI 54311-8321

Phone

(920) 288-8000

NPI assigned

Sep 10, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1811322845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118321",
            "telephone_number": "920-288-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118321",
            "telephone_number": "920-288-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCROY",
        "first_name": "LACEY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "070020112",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "IL",
            "license": "070020112",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070020112",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria M McMeen, MD
• Madeline A McNally, M.D.
• Amy C McNeill, LMT
• Richard Kevin McNutt, MD
• Isaac McQuay
• Jean Marie McWey, M.S. CCC-SLP
• MDC Bellevue, L.L.C.
• Jacob Mead
• Robert Charles Mead, MD
• Meadowbrook Smiles

• Physical Therapist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.