Nicole Bowden Lacy, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

30555 Issued in TN

Practice address

1500 W Poplar Ave Ste 202
Collierville, TN 38017-0601

Phone

(901) 861-9090

NPI assigned

Nov 1, 2021

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

Merit-based Incentive Payment System (MIPS)

Final score

81.87 of 100Reported as group

Quality

64.75

Promoting interoperability

100

Improvement activities

40

Cost

74.81

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.lacy@krogerhealth.eclinicaldirectplus.com
• Direct secure messaging: nlacy608522@direct.bmhcc.org

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.

• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206
  Medicare reassignment Care Compare group NPD
• The Little Clinic of Tennessee LLC

  • Family Nurse Practitioner
  • White House, TN
  • NPI 1487848800
  Medicare reassignment NPD
• Baptist Memorial Medical Group Inc

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1841006129
  NPD

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

• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1881359271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "telephone_number": "901-227-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W POPLAR AVE STE 202",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170601",
            "telephone_number": "901-861-9090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8040 Wolf River Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381775",
            "country_code": "US",
            "telephone_number": "901-726-0200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7205 Wolf River Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381758",
            "country_code": "US",
            "telephone_number": "901-684-1322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6025 Walnut Grove Rd Ste 627",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202126",
            "country_code": "US",
            "telephone_number": "901-767-3321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7715 Wolf River Blvd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381706",
            "country_code": "US",
            "telephone_number": "901-328-6031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1995 Highway 51 S Ste 204",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "TN",
            "postal_code": "380193655",
            "country_code": "US",
            "telephone_number": "901-475-5305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1520 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381043700",
            "country_code": "US",
            "telephone_number": "901-276-2410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8970 Winchester Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381258231",
            "country_code": "US",
            "telephone_number": "901-794-5806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8040 Wolf River Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381773",
            "country_code": "US",
            "telephone_number": "901-725-8606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Exeter Rd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383966",
            "country_code": "US",
            "telephone_number": "901-757-1350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7205 WOLF RIVER LBVD",
            "address_2": "STE 100",
            "address_purpose": "LOCATION",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381758",
            "country_code": "US",
            "telephone_number": "901-684-1322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8040 Wolf River Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381773",
            "country_code": "US",
            "telephone_number": "901-227-7900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1717 W Massey Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381204206",
            "country_code": "US",
            "telephone_number": "901-685-8245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8138 Country Village Dr",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380162029",
            "country_code": "US",
            "telephone_number": "901-725-8606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACY",
        "first_name": "NICOLE",
        "middle_name": "BOWDEN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajackson@tristatechc.com",
            "affiliation": "N",
            "address_1": "4041 Knight Arnold Rd",
            "city": "Memphis",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381182128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajackson@tristatechc.com",
            "affiliation": "N",
            "endpointDescription": "preceptor's email address",
            "address_1": "4041 Knight Arnold Rd",
            "city": "Memphis",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381182128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Walter Koch, MD
• Patricia Hatley Koester, O.D.
• Kroger Limited Partnership I
• Kroger Limited Partnership I
• Gracyn Lee Lacy
• Mary Kathryn Landers, LCSW
• Leigh Ann Landy, FNP-C
• Trevor Lannom
• Jhylen Lathan, RBT
• Laura Finnern, DPT

• Family Nurse Practitioner in Collierville, TN
• Providers in Collierville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.
• 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.