James Dylan Lackey, FNP-BC
Nurse Practitioner, Family in Atlanta, GA. Individual provider (NPI-1).
NPI number1205403151
StatusActive
Last updated in NPPESMay 6, 2024
Details
- NPI
- 1205403151
- Entity type
- Individual (NPI-1)
- Name
- Mr. James Dylan Lackey
- Credential
- FNP-BC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 9, 2021
- Certification date
- May 6, 2024
- Last updated
- May 6, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | RN282621 | GA | Yes |
Practice location
1438 W Peachtree St NwAtlanta, GA 30309-2998
Phone 470-283-7349 · Fax 833-689-2507
Mailing address
6255 W Sunset Blvd Fl 21Los Angeles, CA 90028-7422
Phone 323-860-5200 · Fax 234-677-1193
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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