NPIMap

Individual provider Active NPI

Elijah Austin Lackey, MD

  • Neurology Physician
  • Fort Collins, CO
National Provider Identifier
1821594219
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2022-00049 Issued in CO
Practice address
2121 E Harmony Rd
Fort Collins, CO 80528-3400
Phone
(970) 226-6111
Fax
(970) 226-6707
NPI assigned
Apr 4, 2018
Last updated
Aug 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2022-00049 CO Primary

Addresses

Primary practice location

2121 E Harmony Rd
Fort Collins, CO 80528-3400

Mailing address

2121 E Harmony Rd Unit 180
Fort Collins, CO 80528-3401
Phone (970) 226-6111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elijah.lackey.1@32973.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230627000621 NC Practitioner - Neurology 0042678807
I20251216000918 CO Practitioner - Neurology 0042678807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2121 E Harmony Rd
Unit 180
Fort Collins, CO 80528-3401
Phone (970) 226-6111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2022-00049COMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Neurology of Colorado, LLC Neurology CurrentSince Sep 7, 2025 Accepting new patients
Advanced Neurology of Colorado, LLC PastSince Sep 7, 2025 Accepting new patients

Locations

2121 E Harmony Rd
Unit 180
Fort Collins, CO 80528
Phone (970) 226-6111

1551 Professional Ln
Unit 125
Longmont, CO 80501
Phone (720) 494-3119

Interoperability endpoints

  • Direct secure messaging: elackey401119@direct.medicine.duke.edu
  • Direct secure messaging: elijah.lackey.1@32973.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1821594219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD UNIT 180",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283401",
            "telephone_number": "970-226-6111",
            "fax_number": "970-226-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E HARMONY RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283400",
            "telephone_number": "970-226-6111",
            "fax_number": "970-226-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "ELIJAH",
        "middle_name": "AUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "2022-00049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elijah.lackey.1@32973.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2121 E Harmony Rd",
            "city": "Fort Collins",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805283400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.