RACHAEL CLARK LACKEY (NPI# 1780922849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780922849 |
Entity Type | Individual |
Full Name | RACHAEL CLARK LACKEY |
Credential | ARNP |
Practice Address |
4681 Us Highway 84 Byp W Thomasville GA 31792-2607 |
Mailing Address |
454 Smith Ave Thomasville GA 31792-5535 |
Practice Telephone | 2292272936 |
Practice Fax Number | 2292262036 |
Mailing Telephone | 2295842540 |
Mailing Fax Number | 2292262036 |
Enumeration Date | 2013-01-24 |
Last Update Date | 2017-10-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN224594 | GA | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
ARNP9297951 | FL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | FLORIDA DEPARTMENT OF HEALTH | ARNP9297951 | 01 |
GA | GA LICENSE | RN224594 | 01 |
Street Address |
4681 US HIGHWAY 84 BYP W |
City | THOMASVILLE |
State | GA |
Zip Code | 31792-2607 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407375686 | Primary Care of Southwest Georgia, Inc | Clinic/Center | 4681 Us Highway 84 Byp W, Thomasville, GA 31792-2607 | 2017-09-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245739879 | Georgia Pines Community Service Board | Community/Behavioral Health | 407 Cloverdale Drive, Thomasville, GA 31792 | 2018-02-09 |
1932613551 | Diana Diaz | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792 | 2017-11-17 |
1194249425 | Bobbie Frazier | Contractor | 400 Cloverdale Dr, Thomasville, GA 31792 | 2017-07-28 |
1598132292 | Southern Scripts, LLC | Pharmacy | 501 Gordon Avenue, Thomasville, GA 31792 | 2015-08-28 |
1508248915 | Elizabeth Nicole Keen | Behavioral Analyst | 121 Covington Ave Apt 9, Thomasville, GA 31792 | 2015-06-22 |
1417341579 | Sheila L Stanley | Counselor | 301 Summercreek Cove, Thomasville, GA 31792 | 2015-03-26 |
1457749301 | Ashley Lamb | Speech-Language Pathologist | 1203 East Jackson Street, Thomasville, GA 31792 | 2014-12-30 |
1831403880 | Somnoquest | Durable Medical Equipment & Medical Supplies | 556 Hall Road, Thomasville, GA 31792 | 2010-08-02 |
1508000183 | Kashyap B Choksi | Internal Medicine | 100 Mimosa Drive 2nd Floor, Thomasville, GA 31792 | 2009-04-27 |
1205008786 | Mark J Glaccum | Chiropractor | 415 Gordon Avenue, Thomasville, GA 31792 | 2008-03-25 |
Find all providers in zip 31792 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710594106 | Melanie Hattink | Nurse Practitioner | 101 Meadow Ridge Ct, Thomasville, GA 31792-5091 | 2020-09-29 |
1740828078 | Lauren Reagan | Nurse Practitioner | 2012 E Pinetree Blvd Ste A, Thomasville, GA 31792-5572 | 2019-12-17 |
1548721053 | Lisa Taylor | Nurse Practitioner | 669 Saint Paul Rd, Thomasville, GA 31757-0704 | 2019-03-27 |
1922566181 | Charlene Reynolds | Nurse Practitioner | 119 Holloway Ln, Thomasville, GA 31792-6514 | 2019-03-06 |
1053883561 | Kevin Franklin Garris | Nurse Practitioner | 33621 Highway 43 Ste 202, Thomasville, AL 36784-3309 | 2018-12-21 |
1740751908 | Alethia Cunningham Stephens | Nurse Practitioner | 514 Tanglewood Dr, Thomasville, GA 31792-6836 | 2018-12-16 |
1932670247 | Glenda Laverne Diaz | Nurse Practitioner | 41 Spring Bok Ln, Thomasville, GA 31792-0691 | 2018-12-12 |
1700376910 | Stephanie Diers | Nurse Practitioner | 914 S Broad St, Thomasville, GA 31792-6113 | 2018-05-14 |
1770003592 | Lucas Nathan Williams | Nurse Practitioner | 216 Glen Arven Dr, Thomasville, GA 31792-7414 | 2017-06-22 |
1588011050 | Regenia Durwood Hutchins | Nurse Practitioner | 2691 Fredonia Rd, Thomasville, GA 31757-1038 | 2016-05-15 |
Find all providers in THOMASVILLE |
City | THOMASVILLE |
Zip Code | 31792 |
Please comment or provide details below to improve the information on RACHAEL CLARK LACKEY.
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.