Active NPI
Russell W. Lacey, MD
- Physical Medicine & Rehabilitation Physician
- Richmond, VA
National Provider Identifier
1952720146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 0101264123
- Practice address
- 417 N 11TH St
Richmond, VA 23298 - Phone
- (804) 828-4097
- Fax
- (804) 828-5533
- NPI assigned
- Apr 15, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 0101264123 | VA | Primary |
Addresses
Primary practice location
417 N 11TH St
Richmond, VA 23298
Mailing address
PO Box 91734
Richmond, VA 23291-1734
Phone (804) 358-6100
Other practice location 1
1250 E Marshall St
Richmond, VA 23298-5051
Phone (804) 828-4097
Other practice location 2
11958 W Broad St
Henrico, VA 23233-1007
Phone (804) 360-4669
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534204800000",
"number": "1952720146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 91734",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232911734",
"telephone_number": "804-358-6100",
"fax_number": "804-342-7619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 N 11TH ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "23298",
"telephone_number": "804-828-4097",
"fax_number": "804-828-5533"
}
],
"practiceLocations": [
{
"address_1": "1250 E Marshall St",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232985051",
"country_code": "US",
"telephone_number": "804-828-4097",
"fax_number": "804-828-5533",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11958 W Broad St",
"address_purpose": "LOCATION",
"city": "Henrico",
"state": "VA",
"postal_code": "232331007",
"country_code": "US",
"telephone_number": "804-360-4669",
"fax_number": "804-364-6521",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LACEY",
"first_name": "RUSSELL",
"middle_name": "W.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-15",
"last_updated": "2018-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "VA",
"license": "0101264123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.