MS. JODI JEAN LACKEY (NPI# 1568551729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568551729 |
| Entity Type | Individual |
| Full Name | MS. JODI JEAN LACKEY |
| Credential | MBA, MHA, MMSC, PA-C |
| Practice Address |
200 S Herlong Ave Suite E1 Rock Hill SC 29732 |
| Mailing Address |
200 S Herlong Ave Suite E1 Rock Hill SC 29732-3399 |
| Practice Telephone | 8033241950 |
| Practice Fax Number | 8033241933 |
| Mailing Telephone | 8033241950 |
| Mailing Fax Number | 8033241933 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2012-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
TL1782 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
0010-01518 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3097 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 0723PA | 05 |
| Street Address |
200 S HERLONG AVE SUITE E1 |
| City | ROCK HILL |
| State | SC |
| Zip Code | 29732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821097510 | Joshua Jeremiah Beardsley | Physician Assistant | 200 S Herlong Ave, Suite B, Rock Hill, SC 29732-3399 | 2005-07-15 |
| 1275925828 | Pmc Physician Network, L.L.C. | Neurological Surgery | 200 S Herlong Ave, Suite B, Rock Hill, SC 29732-3399 | 2015-02-19 |
| 1639459027 | Piedmont General Surgery Associates, LLC | Surgery | 200 S Herlong Ave, Suite G, Rock Hill, SC 29732-3399 | 2011-08-17 |
| 1356639025 | Kim Thien Nguyen Ho | Audiologist | 200 S Herlong Ave, Suite A, Rock Hill, SC 29732-3399 | 2011-07-15 |
| 1831400605 | Leann Michelle Rettell | Family Medicine | 200 S Herlong Ave, Rock Hill, SC 29732-3399 | 2010-06-28 |
| 1265661763 | Piedmont Behavioral Medicine Associates, LLC | Behavioral Analyst | 200 S Herlong Ave, Suite C, Rock Hill, SC 29732-3399 | 2009-07-07 |
| 1427214733 | Sarah Elizabeth Vair | Audiologist | 200 S Herlong Ave, Suite A, Rock Hill, SC 29732-3399 | 2008-08-06 |
| 1942488903 | Piedmont Pulmonology, LLC | Internal Medicine | 200 S Herlong Ave, Suite E-1, Rock Hill, SC 29732-3399 | 2008-02-01 |
| 1720279524 | Laura Margarita Cantu Baysinger | Audiologist | 200 S Herlong Ave, Suite A, Rock Hill, SC 29732-3399 | 2007-08-06 |
| 1174667521 | Chad S Kessler | Otolaryngology | 200 S Herlong Ave, Suite A, Rock Hill, SC 29732-3399 | 2007-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023659471 | Jessie M. Armstrong | Counselor | 199 S Herlong Avenue, Rock Hill, SC 29732 | 2019-10-07 |
| 1215407861 | Alicia Johnson | Occupational Therapist | 2025 Ebenezer Rd Suite H, Rock Hill, SC 29732 | 2018-11-27 |
| 1346716909 | Leslie Marie Metzler | Nurse Practitioner | 125 Amendment Ave, Rock Hill, SC 29732 | 2018-10-22 |
| 1356824668 | Laurie E Grove | Counselor | 508 Bethel Street, Clover, SC 29732 | 2018-09-12 |
| 1366924441 | Chinyere Gill-smith | Occupational Therapist | 2390 127 Murrah Drive, Rock Hill, SC 29732 | 2018-09-05 |
| 1053825513 | Community Medicine Foundation Inc | Clinic/Center | 205 Piedmont Blvd. Suite 100, Catawba Community Mental Health Services York Adult Ser, Rock Hill, SC 29732 | 2017-11-20 |
| 1952824906 | Miriam George-norman | Occupational Therapist | 831 Mcdow Drive, Rock Hill, SC 29732 | 2017-07-21 |
| 1255854550 | Courtney Costa | Counselor | 199 S. Herlong Avenue, Rock Hill, NC 29732 | 2017-07-19 |
| 1861913022 | Drs Misiek, Farrell, Farrell, Nale, Cook, Kapitan, Mohamed & Franco Pa | Oral & Maxillofacial Surgery | 1761 Ebenezer Road, Rock Hill, SC 29732 | 2017-06-28 |
| 1396275806 | Chrysalis Autism Center, Inc | Assistant Behavior Analyst | 1547 Cherry Rd, Rock Hill, SC 29732 | 2017-06-16 |
| Find all providers in zip 29732 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417209610 | Michael Collins Hadley | Physician Assistant | 200 S Herlong Ave Ste B, Rock Hill, SC 29732-1182 | 2012-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689140451 | Nichole Lemay | Physician Assistant | 9 Richland Medical Park Dr Ste 640, Columbia, SC 29203 | 2018-10-19 |
| 1588183909 | John Edward Carpenter | Physician Assistant | 50 E Hospital St Ste 6, Manning, SC 29102-3149 | 2017-09-18 |
| 1689116006 | Healing Hands Surgical Assisting | Physician Assistant | 456 Bates Crossing Rd, Travelers Rest, SC 29690-9277 | 2016-11-16 |
| 1003207101 | Kimberly Anne Caldwell | Physician Assistant | 306 Roosevelt Ave, Travelers Rest, SC 29690-1750 | 2015-02-10 |
| 1144653742 | Carrie Marie Thompson | Physician Assistant | 96 Jonathan Lucus Street, Csb He320e, Charleston, SC 29425 | 2013-08-19 |
| 1437400363 | William Travis Jeffcoat | Physician Assistant | 109 Health Way, Anderson, SC 29621-3333 | 2012-10-02 |
| 1609184316 | Kym L Kittle | Physician Assistant | 161 Ashley Ave, Charleston, SC 29425-8905 | 2010-09-15 |
| 1093960957 | Stephen Utenick | Physician Assistant | 105 Beason Farm Ln, Simpsonville, SC 29681-6509 | 2008-11-19 |
| 1689849457 | First Surgical Associates, LLC | Physician Assistant | 1004 Wells St, Bennettsville, SC 29512-2718 | 2008-04-23 |
| 1922270594 | Kati George Carter | Physician Assistant | 890 W Faris Rd Ste 550, Greenville, SC 29605-4286 | 2008-03-24 |
| Find all providers with the same taxonomy | ||||
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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.