Individual provider Active NPI

Lacey Jo Myers I, ARNP

  • Nurse Practitioner
  • Ankeny, IA
National Provider Identifier
1821461344
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A128569 Issued in IA
Practice address
1325 NE 31St St
Ankeny, IA 50021-6695
Phone
(515) 279-1959
Fax
(515) 289-0888
NPI assigned
Nov 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A128569 IA Primary

Addresses

Primary practice location

1325 NE 31St St
Ankeny, IA 50021-6695

Mailing address

2213 Grand Ave
Des Moines, IA 50312-5305
Phone (515) 237-3974

Other identifiers 2

IdentifierTypeStateIssuer
I43700006OtherIAMEDICARE PTAN MMP
IB3557001OtherIAMEDICARE PTAN TEAMMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151229001215 IA Practitioner - Nurse Practitioner 2365743820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 Pleasant St
Suite 200
Des Moines, IA 50309-1424
Phone (515) 241-8221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A128569IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Jan 8, 2018 Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1221 Pleasant St
Ste 200
Des Moines, IA 50309
Phone (515) 241-8221

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

Interoperability endpoints

  • Direct secure messaging: lmyers605224@direct.unitypoint.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1821461344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125305",
            "telephone_number": "515-237-3974",
            "fax_number": "515-883-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 NE 31ST ST",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500216695",
            "telephone_number": "515-279-1959",
            "fax_number": "515-289-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "LACEY",
        "middle_name": "JO",
        "name_suffix": "I",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A128569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN MMP",
            "identifier": "I43700006",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN TEAMMD",
            "identifier": "IB3557001",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

Verify at the official NPI Registry.