DR. SHANON RENEE LACY (NPI# 1003076142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003076142 |
| Entity Type | Individual |
| Full Name | DR. SHANON RENEE LACY |
| Credential | D.O. |
| Practice Address |
8901 W Lincoln Ave West Allis WI 53227-2409 |
| Mailing Address |
102 N Water St Unit 206 Milwaukee WI 53202-6056 |
| Practice Telephone | 4143287675 |
| Mailing Telephone | 3172859918 |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2012-07-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZD0900X |
Pathology Specialization: Dermatopathology |
56999-21 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
8901 W LINCOLN AVE |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53227-2409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982603957 | Frederick A Heiden | Anesthesiology | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2005-07-20 |
| 1801496500 | Laney Marie Hemer | Physical Therapist | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2020-10-30 |
| 1649888389 | Melissa A Jackson | Registered Nurse | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2020-07-20 |
| 1679193494 | Jade Noel | Physical Therapy Assistant | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2020-04-22 |
| 1740800606 | Andrew Wieting | Physical Medicine & Rehabilitation | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2020-04-21 |
| 1104455864 | Andrew D Merkel | Physical Therapist | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2020-04-05 |
| 1649807645 | Megan Devine | Speech-Language Pathologist | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2020-03-27 |
| 1144858002 | Rachel Ball-tobin | Massage Therapist | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2020-03-27 |
| 1093353583 | Mckayla Figueroa | Physical Therapist | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2019-12-15 |
| 1407417629 | Stacy Neumann | Occupational Therapist | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2019-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451564 | Ginger Renee Bland | Nurse Practitioner | 11133 W. National Avenue, West Allis, WI 53227 | 2020-06-12 |
| 1003312141 | Dynamic Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 10236 W National Ave, West Allis, WI 53227 | 2018-04-05 |
| 1932572641 | Alissa Kristine Walker | Specialist/Technologist | 11601 W Lincoln Ave, West Allis, WI 53227 | 2015-11-03 |
| 1396155990 | Bradly Earl Helinski | Physical Therapy Assistant | 3023 S 84th St., Milwaukee, WI 53227 | 2014-05-05 |
| 1609299783 | Amy Renee Rozumalski | Occupational Therapy Assistant | 10150 W. National Ave, Suite 150, Premiere Medical Staffing Services, LLC, Milwaukee, WI 53227 | 2014-01-27 |
| 1497098438 | Kathleen Marie Schneider | Physical Therapy Assistant | 3023 S. 84th Street, Milwaukee, WI 53227 | 2013-03-28 |
| 1760723373 | Lee Ann Schraith | Physical Therapy Assistant | 3023 S. 84th St, Milwaukee, WI 53227 | 2013-03-06 |
| 1740520725 | Samantha Lynn Wozniak | Physical Therapist | 3023 S. 84th St., Milwaukee, WI 53227 | 2013-02-27 |
| 1831434901 | Andrew Paul Roeder | Physical Therapy Assistant | 3023 S. 89th Street, Milwaukee, WI 53227 | 2012-11-30 |
| 1538418116 | Christine Wilford | Social Worker | 2044 S 96th Street, West Allis, WI 53227 | 2012-08-29 |
| Find all providers in zip 53227 | ||||
| Taxonomy Code | 207ZD0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Dermatopathology |
| A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source added] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. A subspecialty certificate was first issued by the ABMS in 1974. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881734028 | Cris Patrick Myers | Pathology | 1969 W Hart Rd, Beloit, WI 53511-2230 | 2007-02-07 |
| 1881796001 | Chafik Bengana | Pathology | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2006-09-01 |
| 1912944752 | Song Qing Zhao | Pathology | 801 York St, Manitowoc, WI 54220 | 2006-06-01 |
| 1841255122 | Andrew R Virata | Pathology | 1400 Bellinger St, Eau Claire, WI 54703-5222 | 2006-04-19 |
| 1922063239 | Sarah R Hughes | Pathology | 1836 South Ave, La Crosse, WI 54601-5429 | 2006-04-19 |
| 1700863685 | Scott W. Kelley | Pathology | 12805 W Burleigh Rd, Suite 200, Brookfield, WI 53005-3111 | 2005-12-30 |
| City | WEST ALLIS |
| Zip Code | 53227 |
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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.