Active NPI
Lacey N McMahill, APN
- Family Nurse Practitioner
- Canton, IL
National Provider Identifier
1851891071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.016917
- Practice address
- 180 S Main St
Canton, IL 61520-2608 - Phone
- (309) 647-0201
- Fax
- (309) 649-6800
- NPI assigned
- Feb 14, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.016917 | IL | Primary |
Addresses
Primary practice location
180 S Main St
Canton, IL 61520-2608
Mailing address
180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201
Other names 1
- Lacey Ham
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lacey.mcmahill@gmgil.eclinicaldirectplus.com | Health Information Exchange (HIE) | Graham Hospital Association |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180321002648 | IL | Practitioner - Nurse Practitioner | 2365704889 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.016917 | IL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617840000000",
"number": "1851891071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 S MAIN ST",
"city": "CANTON",
"state": "IL",
"postal_code": "615202608",
"telephone_number": "309-647-0201",
"fax_number": "309-647-8613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 S MAIN ST",
"city": "CANTON",
"state": "IL",
"postal_code": "615202608",
"telephone_number": "309-647-0201",
"fax_number": "309-649-6800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHILL",
"first_name": "LACEY",
"middle_name": "N",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-14",
"last_updated": "2021-04-08",
"certification_date": "2021-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.016917",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lacey.mcmahill@gmgil.eclinicaldirectplus.com",
"affiliation": "Y",
"affiliationName": "Graham Hospital Association",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "180 S Main St",
"city": "Canton",
"state": "IL",
"country_code": "US",
"postal_code": "615202608",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LACEY",
"last_name": "HAM",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Canton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.