Brian Michael Lackey, P.T,

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH2793 Issued in AL

Practice address

924 Plantation Blvd Ste B
Fairhope, AL 36532-7308

Phone

(251) 928-0600

Fax

(251) 928-6137

NPI assigned

Oct 5, 2005

Last updated

Oct 5, 2018By the provider in NPPES

Sex

Male

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

Enrolled in AL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of South Alabama College of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sixfourthree, LLCGroup PAC ID 7719957976, 47 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Espt Fairhope LLC

  dba Eastern Shore Physical Therapy

  • Physical Therapy Clinic/Center
  • Fairhope, AL
  • NPI 1396236378

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Sixfourthree, LLC

  dba Fairhope Physical Therapy Services

  • Exclusive Provider Organization
  • Huntsville, AL
  • NPI 1396781209
  Medicare reassignment Care Compare group NPD
• Sixfourthree, LLC

  dba Johnson and Hayes Physical Therapists

  • Exclusive Provider Organization
  • Madison, AL
  • NPI 1649828328
  NPD

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1871580746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 PECAN AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 PLANTATION BLVD STE B",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365327308",
            "telephone_number": "251-928-0600",
            "fax_number": "251-928-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "credential": "P.T,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH2793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "51098701",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Beth Kozee, PH.D.
• Mary Beth Fisher Krepinevich, MSW
• William Kutsche, DO
• Kyle Lopez DC PC (Advanced Health Solutions)
• Kayla Leist Labrato, CRNP
• Lagniappe Dental PLLC
• Jennifer Elizabeth Lambert, CRNP
• Wealthy Ann Lambert, LPC
• Julia Lanaux, LPC
• Richard Jeptha Lancaster, M.D.

• Physical Therapist in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.