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LACEY POE APRN
NPI 1205069630
Nurse Practitioner - Family in Manila, AR

Active since September 02, 2009PECOS Enrolled
3644 W ST HWY 18, SUITE B, MANILA, AR 72442(870) 561-3300(870) 561-3307 Get Directions Write a Review

NPPES record last updated: February 18, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lacey Poe Aprn NPPES

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

LACEY POE APRN (NPI 1205069630) is an individual family provider in Manila, Arkansas, licensed in Arkansas (A03280) and active in the NPI registry since September 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205069630
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameLACEY POECredential: APRN
Location Address3644 W ST HWY 18, SUITE BManila, AR 72442
Mailing AddressPo Box 910Manila, AR 72442-0910 · (870) 561-3300 · Fax (870) 561-3307
Phone(870) 561-3300
Fax(870) 561-3307
Sole ProprietorNo
Enumeration DateSeptember 2, 2009
Last NPPES UpdateFebruary 18, 2014
✔ NPI 1205069630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AR · A03280
3644 W ST HWY 18, Manila, AR 72442
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Other Identifiers 4

Medicaid179499758AR
Medicare PIN4A2167297AR
Medicare PIN57297AR
Medicare PIN5V2577297AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lacey Poe Aprn 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72442 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.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers13 claims23 services$5.46 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier12 claims12 services$47.51 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers22 claims22 services$112.60 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier11 claims11 services$38.18 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

TOMMY W WAGNER MD
Family Medicine
3644 W ST HWY 18
MANILA, AR 72442
Mississippi County (870) 561-3300
HEATHER LEIGH SMITH APN
Nurse Practitioner
3644 W ST HWY 18, SUITE B
MANILA, AR 72442
Mississippi County (870) 561-3300
DANNA SCOTT DEATON APRN
Nurse Practitioner (Family)
3644 W ST HWY 18, SUITE B
MANILA, AR 72442
Mississippi County (870) 561-3300

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 Lacey Poe's NPI number?

The NPI number for Lacey Poe is 1205069630. It was assigned to this individual provider in the NPPES registry on September 2, 2009.

Where is Lacey Poe located?

Lacey Poe practices at 3644 W St Hwy 18 Suite B, Manila, AR 72442. The listed phone number is (870) 561-3300.

What is Lacey Poe's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Lacey Poe enrolled in Medicare?

Yes. Lacey Poe is registered in the Medicare PECOS enrollment system.

What insurance does Lacey Poe accept?

Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Lacey Poe as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lacey Poe was last updated on February 18, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.