MR. JAMES DYLAN LACKEY FNP-BC NPI 1205403151

NPI Information

  • NPI: 1205403151
  • Provider Name: MR. JAMES DYLAN LACKEY, FNP-BC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1438 W PEACHTREE ST NW
    ATLANTA, GA
    ZIP 30309
  • Phone: (470) 283-7349

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NPI Details

MR. James Dylan Lackey, FNP-BC is a family nurse practitioner in Atlanta, GA with 7 years of experience. MR. James Dylan Lackey, FNP-BC NPI is 1205403151. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduation Year:2018

The provider's business location address is:

1438 W PEACHTREE ST NW
ATLANTA, GA
ZIP 30309-998
Phone: (470) 283-7349
Fax: (833) 689-2507

The NPI 1205403151 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/9/2021 and was last updated on 5/6/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyRN282621GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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