Lacey T Hodgson, ARNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1744102 Issued in FL

Practice address

2137 Little Rd
Trinity, FL 34655-4410

Phone

(727) 372-6760

Fax

(727) 372-6808

NPI assigned

Sep 7, 2007

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60913

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.

• East Lake Pediatrics

  • Pediatrics Physician
  • Trinity, FL
  • NPI 1144343617
  NPD

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1841485380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554410",
            "telephone_number": "727-372-6760",
            "fax_number": "727-372-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554410",
            "telephone_number": "727-372-6760",
            "fax_number": "727-372-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGSON",
        "first_name": "LACEY",
        "middle_name": "T",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "1744102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3977688349",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenny Hernandez, MD
• Tatiana Luz Hernandez, MD
• Jeffrey Hickey
• Zachary Hinkle
• Jonathan Goodwin Hisghman II, D.O.
• Katharine Teresa Hoffman, MD
• Holiday CVS LLC
• Holy Trinity Pharmacy LTC LLC
• Holy Trinity Pharmacy, LLC
• Hope for Healing Counseling, LLC

• Pediatric Nurse Practitioner in Trinity, FL
• Providers in Trinity, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.