Phillip Limbaugh Lackey, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

42124 Issued in KY

Practice address

1540 Spring Valley Dr
Huntington, WV 25704-9501

Phone

(304) 429-6741

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Merit-based Incentive Payment System (MIPS)

Final score

84.04 of 100Reported as group

Quality

60.55

Promoting interoperability

100

Improvement activities

40

Cost

78.81

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: plackey85442@direct.kdhealth.us

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.

• Kings Daughters Medical Specialties Inc

  dba Kings Daughters Medical Specialities ENT

  • Otolaryngology Physician
  • Ashland, KY
  • NPI 1497083539

  OH

  Medicare reassignment NPD
• Kings Daughters Medical Specialties Inc

  dba Kings Daughters Medical Specialities Physical Medicine and Rehab

  • Physical Medicine & Rehabilitation Physician
  • Prestonsburg, KY
  • NPI 1710215736
  Medicare reassignment NPD
• Kings Daughters Medical Specialties Inc

  dba Kings Daughters Medical Specialties Tri State Regional Cancer Center

  • Radiation Oncology Physician
  • Ashland, KY
  • NPI 1699565176
  NPD
• Kings Daughters Medical Specialties Inc

  dba Kings Daughters Medical Specialties - Plastic & Reconstructive Surgeon

  • Plastic Surgery Physician
  • Ashland, KY
  • NPI 1720397409
  NPD

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1902929219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 SPRING VALLEY DR",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257049501",
            "telephone_number": "304-429-6741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 23rd St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "KY",
            "postal_code": "411012890",
            "country_code": "US",
            "telephone_number": "606-408-7500",
            "fax_number": "606-408-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "PHILLIP",
        "middle_name": "LIMBAUGH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "OH",
            "license": "35.113919",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "AL",
            "license": "23570",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "KY",
            "license": "42124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000568865",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2853050",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100048660",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keerthi Kunchala, MBBS
• Stephanie Ann Kunze
• Enid Kurtz, MD
• Walter Kusiak
• Donna Kay Lacey
• Sarah Lackey, DO
• Lacy Davidson, Ms, RDN, LD, Ryt, LLC
• Blake Michael Lacy
• Karlie S Lafauci
• Savannah Lafferty

• Plastic and Reconstructive Surgery Physician in Huntington, WV
• Providers in Huntington, WV by specialty
• Plastic and Reconstructive Surgery Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.