Constance Sue Lackner, MSN APRN BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

7278 Issued in TN

Practice address

101 Lena Dr
Rogersville, TN 37857-2951

Phone

(423) 272-9239

Fax

(423) 272-1803

NPI assigned

Mar 24, 2006

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

Other identifiers 3

Other names 1

• Miss Constance Sue Lackner Former name

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, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Frontier HealthGroup PAC ID 2860302320, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science - Nursing, Nurse Practitioner

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.

• Frontier Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gray, TN
  • NPI 1720147408
  Medicare reassignment Care Compare group NPD
• Frontier Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sneedville, TN
  • NPI 1053475558
  NPD
• Kingsport Psychiatry & Counseling Services, PLLC

  • Psychiatry Physician
  • Kingsport, TN
  • NPI 1790176667
  NPD (past)
• Takoma Hospital & Sanitarium Training School, Inc.

  • Psychiatric Hospital Unit
  • Greeneville, TN
  • NPI 1811915838
  NPD (past)
• Tricare Behavorial Health LLC

  • Community/Behavioral Health Agency
  • Kingsport, TN
  • NPI 1891844973
  NPD (past)
• Tricare Behavorial Health, LLC Group

  • Mental Health Counselor
  • Kingsport, TN
  • NPI 1750599650
  NPD (past)
• Regional Health Resources Inc

  • Rural Health Clinic/Center
  • Duffield, VA
  • NPI 1841415619
  NPD (past)
• Regional Health Resources, Inc

  • Primary Care Clinic/Center
  • Duffield, VA
  • NPI 1487681771
  NPD (past)
• Wellmont Physician Services Inc

  • Internal Medicine Physician
  • Big Stone Gap, VA
  • NPI 1619095403
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1922068022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205",
            "telephone_number": "423-467-3600",
            "fax_number": "423-467-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LENA DR",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378572951",
            "telephone_number": "423-272-9239",
            "fax_number": "423-272-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKNER",
        "first_name": "CONSTANCE",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "MSN APRN BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024182053",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "7278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3143910",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PROVIDER",
            "identifier": "890000552",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3345085",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONSTANCE",
            "last_name": "LACKNER",
            "middle_name": "SUE",
            "prefix": "MISS",
            "credential": "MSN APRN BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tara Beth Kimbro
• Kimberly S Kirkpatrick, DPH
• Lindsey Raye Kiser, PHARMD
• Raymond J Krenzer
• Alaina M Kuebler, OTR
• Christopher A Landess, MD
• Jennifer E. Lane, N.P.
• Winter Brooke Larkin, PHARM.D.
• Courtney Nicole Lawson, RDH
• G G Lawson

• Psychiatric/Mental Health Nurse Practitioner in Rogersville, TN
• Providers in Rogersville, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.