Lacy Culver Vincent, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

310464 Issued in LA

Practice address

4396 Highway 80
Ruston, LA 71270-8948

Phone

(318) 550-8928

NPI assigned

Nov 5, 2018

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

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: lvincent412751@christushealth.direct-ci.net

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.

• Highland Emergency Group, LLC

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1154913861
  Medicare reassignment

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1831667104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4396 HIGHWAY 80",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712708948",
            "telephone_number": "318-251-4659",
            "fax_number": "318-513-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4396 HIGHWAY 80",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712708948",
            "telephone_number": "318-550-8928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "LACY",
        "middle_name": "CULVER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "310464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valid Voices Counseling Agency
• Marti Bordenlon Vandagriff, RDN LDN CDCES
• Herbert F Vandenberg, M.D.
• Jerrilyn Frasier Vaughan, AU.D., L-SLP/A
• Jared Mark Vincent, MD
• Vision Associates Inc
• Cynthia Paige Volentine
• Patricia D Volentine, CRNA
• Leslie Nicole Vowles, PT
• Kristi Wade

• Physician Assistant in Ruston, LA
• Providers in Ruston, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.