Individual provider Active NPI

Lacey Lansford, FNP-BC

  • Nurse Practitioner
  • Jefferson City, MO
National Provider Identifier
1932965837
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2024000882 Issued in MO
Practice address
1241 W Stadium Blvd
Jefferson City, MO 65109-6023
Phone
(573) 634-4878
NPI assigned
Feb 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2024000882 MO Primary

Addresses

Primary practice location

1241 W Stadium Blvd
Jefferson City, MO 65109-6023

Mailing address

1915 Strassner Rd
Hermann, MO 65041-4417
Phone (573) 418-4675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20240312003662 MO Practitioner - Nurse Practitioner 3173969128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson City Medical Group PCGroup PAC ID 1850371089, 117 clinicians

Practice addresses (Care Compare)

1241 W Stadium Blvd
Jefferson City, MO 65109-6023
Phone (573) 556-5771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson City Medical Group, P.C. Current Accepting new patients
Jefferson City Medical Group, P.C. CurrentSince May 1, 2024 Accepting new patients
Jefferson City Medical Group, P.C. CurrentSince May 1, 2024 Accepting new patients
Jefferson City Medical Group, P.C. Current Accepting new patients

Locations

350 Country Meadow Ln
Fulton, MO 65251
Phone (573) 634-4878

1735 Elm Ct
Jefferson Cty, MO 65101
Phone (573) 634-4878

1241 W Stadium Blvd
Jefferson Cty, MO 65109
Phone (573) 556-5771

Interoperability endpoints

  • Direct secure messaging: lacey.lansford@jcmg.eclinicaldirectplus.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1932965837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 STRASSNER RD",
            "city": "HERMANN",
            "state": "MO",
            "postal_code": "650414417",
            "telephone_number": "573-418-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 W STADIUM BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651096023",
            "telephone_number": "573-634-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANSFORD",
        "first_name": "LACEY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2024000882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.