Active NPI
Lacey Leann Weston, LPTA
- Physical Therapy Assistant
- Melbourne, AR
National Provider Identifier
1962539338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2053
- Practice address
- 889 East Main St.
Melbourne, AR 72556 - Phone
- (870) 368-4586
- Fax
- (870) 368-4587
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 2053 | AR | Primary |
Addresses
Primary practice location
889 East Main St.
Melbourne, AR 72556
Mailing address
P.O. Box 134
Sage, AR 72573
Phone (870) 291-0361
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122852742 | Medicaid | AR | |
| 145863778 | Medicaid | AR | |
| 160417721 | Medicaid | AR |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2053 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids El Melbourne | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Neurodevelopmental Disabilities Physician
- Melbourne, AR
- NPI 1265955512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660003200000",
"number": "1962539338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 134",
"city": "SAGE",
"state": "AR",
"postal_code": "72573",
"telephone_number": "870-291-0361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "889 EAST MAIN ST.",
"city": "MELBOURNE",
"state": "AR",
"postal_code": "72556",
"telephone_number": "870-368-4586",
"fax_number": "870-368-4587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESTON",
"first_name": "LACEY",
"middle_name": "LEANN",
"name_prefix": "Mrs.",
"credential": "LPTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2022-08-09",
"certification_date": "2022-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AR",
"license": "2053",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "122852742",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "145863778",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "160417721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.