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DAVON LACKIE
NPI 1063803567
Nurse Practitioner - Acute Care in Searcy, AR

Active since February 05, 2015PECOS Enrolled
103 WOODLANE DR, SEARCY, AR 72143(501) 268-3733 Get Directions Write a Review

NPPES record last updated: October 6, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Davon Lackie NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVON LACKIE (NPI 1063803567) is an individual acute care provider in Searcy, Arkansas, licensed in Arkansas (A004220) and active in the NPI registry since February 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063803567
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameDAVON LACKIE
Location Address103 WOODLANE DRSearcy, AR 72143-6113
Mailing Address103 Woodlane DrSearcy, AR 72143-6113
Phone(501) 268-3733
Sole ProprietorNo
Enumeration DateFebruary 5, 2015
Last NPPES UpdateOctober 6, 2021
NPPES CertifiedOctober 6, 2021
✔ NPI 1063803567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in AR · A004220
103 WOODLANE DR, Searcy, AR 72143
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Davon Lackie is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Davon Lackie reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St. Vincent Infirmary Medical Center
40 mi
Emergency Medicine
2215 WILDWOOD AVE
Sherwood, AR 72120
  • Reassigned Medicare billing, Arkansas enrollment
  • 77 clinicians in this Medicare group
NPI 1134513906 (501) 552-7100
St. Vincent Medical Group
48 mi
Family Medicine
2 ST. VINCENT CIRCLE
Little Rock, AR 72205
  • Reassigned Medicare billing, Arkansas enrollment
  • 288 clinicians in this Medicare group
NPI 1134176480 (501) 552-3571

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72143 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$79.72 typical visit price
range $51.36 – $157.74
Typical copayment $19.93 (range $12.84 – $39.43)
Most-billed visit code 99203
Established Patient
$91.63 typical visit price
range $16.16 – $128.77
Typical copayment $22.90 (range $4.04 – $32.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARLEY ANN MADDEN APRN
Nurse Practitioner (Family)
103 WOODLANE DR
SEARCY, AR 72143
White County (501) 268-3733
BETTY HUTCHINSON APRN
Nurse Practitioner
103 WOODLANE DR
SEARCY, AR 72143
White County (501) 268-3733
MRS. LACEY ELIZABETH HASTINGS LCSW
Social Worker
103 WOODLANE DR
SEARCY, AR 72143
White County (501) 268-3733
TIMOTHY MCNEIL KILLOUGH MD
Family Medicine
103 WOODLANE DR
SEARCY, AR 72143
White County (501) 268-3733
ARCARE
Clinic/Center (Federally Qualified Health Center (FQHC))
103 WOODLANE DR
SEARCY, AR 72143
White County (870) 347-2534
WHITE COUNTY MEDICAL CENTER
Clinic/Center (Primary Care)
103 WOODLANE DR
SEARCY, AR 72143
White County (501) 268-3733
TIMOTHY M KILLOUGH MD PA
Family Medicine
103 WOODLANE DR
SEARCY, AR 72143
White County (501) 268-3733

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Davon Lackie's NPI number?

The NPI number for Davon Lackie is 1063803567. It was assigned to this individual provider in the NPPES registry on February 5, 2015.

Where is Davon Lackie located?

Davon Lackie practices at 103 Woodlane Dr, Searcy, AR 72143. The listed phone number is (501) 268-3733.

What is Davon Lackie's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Davon Lackie enrolled in Medicare?

Yes. Davon Lackie is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Davon Lackie's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Davon Lackie reassigns Medicare benefits to 2 organizations: St. Vincent Infirmary Medical Center (Sherwood, AR) and St. Vincent Medical Group (Little Rock, AR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Davon Lackie's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Davon Lackie was last updated on October 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.