Monica Shawntae Lackey, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

10933 Issued in NC

Practice address

150 Ken Dwiggins Dr
Mocksville, NC 27028-2439

Phone

(336) 751-1209

NPI assigned

Mar 16, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Paragon Outpatient Rehabilitation Services, LLC

  • Rehabilitation Clinic/Center
  • Roxboro, NC
  • NPI 1245014380
  NPD
• Paragon Outpatient Rehabilitation Services, LLC

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1871867325
  NPD
• Complete Rehab

  • Occupational Therapist
  • Clemmons, NC
  • NPI 1699967547
  NPD (past)

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

{
    "created_epoch": "1552694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1891254199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 KINGS MEADOW DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271274929",
            "telephone_number": "704-622-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 KEN DWIGGINS DR",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282439",
            "telephone_number": "336-751-1209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6000 Meadowbrook Mall Ct Ste 22",
            "address_purpose": "LOCATION",
            "city": "Clemmons",
            "state": "NC",
            "postal_code": "270128775",
            "country_code": "US",
            "telephone_number": "336-778-0292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "337 Hospital St",
            "address_purpose": "LOCATION",
            "city": "Mocksville",
            "state": "NC",
            "postal_code": "270282060",
            "country_code": "US",
            "telephone_number": "336-751-2175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3150 Burke Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036431",
            "country_code": "US",
            "telephone_number": "336-768-5656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "MONICA",
        "middle_name": "SHAWNTAE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-16",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "10933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Douglas Kimberly, M.D.
• Claire Grace King
• Jennifer Kmen, PHARM D
• Brandi Nicole Knight-Harris, MA/EDS, NCC, LPC
• Adam N. Koontz
• Steven G Laymon, OD
• Londry & Modlin VII DDS PLLC
• Londry & Modlin Xix DDS PLLC
• Lindsey Lowtharpe, LCSW
• Magnolia Place

• Occupational Therapist in Mocksville, NC
• Providers in Mocksville, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.