LACEY RENEE NELSON (NPI# 1639467806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639467806 |
| Entity Type | Individual |
| Full Name | LACEY RENEE NELSON |
| Other Name | LACEY RENEE BRYAN |
| Credential | PA-C |
| Practice Address |
2790 Clay Edwards Dr Ste 1230 N Kansas City MO 64116-3253 |
| Practice Telephone | 8168413805 |
| Practice Fax Number | 8162149330 |
| Mailing Telephone | 8168413805 |
| Mailing Fax Number | 8162149330 |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2017-06-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2015004697 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821594532 | Lacey Nelson | Speech-Language Pathologist | 4035 S 500 E, Murray, UT 84107-1866 | 2018-04-02 |
| 1013227990 | Lacey Nelson | Massage Therapist | 3229 Broadway St, Suite G, North Bend, OR 97459-2203 | 2010-10-13 |
| Street Address |
2790 CLAY EDWARDS DR STE 1230 |
| City | N KANSAS CITY |
| State | MO |
| Zip Code | 64116-3253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972064277 | Colin Scott Phillips | Physician Assistant | 2790 Clay Edwards Dr Ste 1230, N Kansas City, MO 64116-3253 | 2019-03-28 |
| 1790246007 | Nathanial L Horton | Physician Assistant | 2790 Clay Edwards Dr Ste 1230, N Kansas City, MO 64116 | 2019-03-28 |
| 1750475836 | Steven B Smith | Specialist | 2790 Clay Edwards Dr Ste 1230, N Kansas City, MO 64116-3253 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326503830 | Ladeja Holland | Student in an Organized Health Care Education/Training Program | 4421 N Oak Trfy, Kansas City, MO 64116 | 2019-02-08 |
| 1982179388 | Casady's Counseling | Counselor | 1201 Nw Briarcliff Pkwy Ste 200 Office233, Kansas City, MO 64116 | 2018-10-11 |
| 1427543818 | Amanda E Foster | Physical Therapist | 3810 N Mulberry Drive 202, Kansas City, MO 64116 | 2018-06-27 |
| 1992290555 | Lucas J Mathes | Physician Assistant | 2790 Clay Edwards Drive, Suite 650, North Kansas City, MO 64116 | 2018-06-26 |
| 1952828816 | Danielle Marie Rush | Physical Therapist | 1501 Nw 38th St., Apt. 305, Kansas City, MO 64116 | 2017-08-23 |
| 1992229629 | Ankita Bhakta | Physical Therapy Assistant | 4407 N Mulberry Dr, Kansas City, MO 64116 | 2017-08-03 |
| 1720430945 | Deon Hicks | Physical Therapist | 851 Nw 45th Street, Suite 209, Kansas City, MO 64116 | 2016-07-12 |
| 1851712228 | Cindy Eldridge | Counselor | 1201 Nw Briarcliff Pkwy Ste 200, Kansas City, MO 64116 | 2014-01-02 |
| 1841629904 | Jamie Lyn Jackson | Specialist/Technologist | 2790 Clay Edwards Dr. Ste #650, North Kansas City, MO 64116 | 2013-11-08 |
| 1487099388 | Lisa M Grasing | Family Medicine | 4150 N. Mulberry Dr, Suite 160, Kansas City, MO 64116 | 2013-05-06 |
| Find all providers in zip 64116 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184259079 | Dustin Edward Hemker | Physician Assistant | 937 Blake Ct, Saint Peters, MO 63376-5527 | 2020-03-11 |
| 1730669169 | Hannah Eagleburger | Physician Assistant | 4321 Wornall Rd, Ste 530, Kansas City, MO 64111 | 2018-08-15 |
| 1770073587 | Ashton Marie Roberts | Physician Assistant | 1 Hospital Dr # Dc077.00, Columbia, MO 65212-1000 | 2018-05-16 |
| 1295257285 | Katelynn Elizabeth Austin | Physician Assistant | 3250 Gordonville Rd Ste 384, Cape Girardeau, MO 63703-5095 | 2017-07-11 |
| 1407214364 | Kathryn Rebecca Bachman | Physician Assistant | 226 S Woods Mill Rd Ste 35w, Chesterfield, MO 63017-3442 | 2016-02-08 |
| 1699148429 | Michael Farrell | Physician Assistant | 7827 Highway N Ste 104, O Fallon, MO 63368-6704 | 2015-11-02 |
| 1427441492 | Cornerstone First Assisting | Physician Assistant | 267 Countryshire Dr, Lake St Louis, MO 63367-5823 | 2015-03-14 |
| 1205232915 | Pa Staffing LLC | Physician Assistant | 408 Ballwin Ave, Ballwin, MO 63021-5213 | 2014-11-06 |
| 1568702090 | Jamie Lyn Mertz | Physician Assistant | 9423 N Wayne Ct, Kansas City, MO 64155-2999 | 2013-02-20 |
| 1245586536 | Jeb Medical LLC | Physician Assistant | 1215 Clay St, Kansas City, MO 64116-4026 | 2012-07-24 |
| Find all providers with the same taxonomy | ||||
| City | N KANSAS CITY |
| Zip Code | 64116 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.