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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JUSTIN TREVOR LACKEY MD
NPI 1497333512
Anesthesiology in Winston Salem, NC

Active since March 30, 2021PECOS Enrolled
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157(336) 716-7246(336) 716-8773 Get Directions Write a Review

NPPES record last updated: September 17, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 17, 2026, Oct 3, 2024, Jul 9, 2024 and 1 more (4 updates tracked since 2021).

About Justin Trevor Lackey Md NPPES

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

JUSTIN TREVOR LACKEY MD (NPI 1497333512) is an individual anesthesiology provider in Winston Salem, North Carolina, licensed in North Carolina (2024-00552) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS and maintains a secondary practice location in High Point.

NPPES Registry Identity

NPI1497333512
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameJUSTIN TREVOR LACKEYCredential: MD
Location AddressMEDICAL CENTER BLVDWinston Salem, NC 27157-3465
Mailing AddressMedical Center BlvdWinston Salem, NC 27157-3465 · (336) 716-7246 · Fax (336) 716-8773
Phone(336) 716-7246
Fax(336) 716-8773
Sole ProprietorNo
Enumeration DateMarch 30, 2021
Last NPPES UpdateSeptember 17, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2026
✔ NPI 1497333512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in NC · 2024-00552
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 0101281117 (VA)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 317799 (NC)
MEDICAL CENTER BLVD, Winston Salem, NC 27157
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Secondary Practice Location 1

Location 1601 N Elm StHigh Point, NC 27262-4331 · Phone (336) 878-6000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Trevor Lackey Md 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.

Other Providers at the Same Location NPPES 20

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

CRAIG MICHAEL COMBS MD
Anesthesiology
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-2255
MR. KAMRON YORK BENFIELD PA
Physician Assistant (Medical)
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4838
ANDREA WHITLEY PEYTON PA-C
Physician Assistant (Medical)
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-2011
AMR SHERIF MOHAMED RIFAA EL HARAKI MD
Obstetrics & Gynecology
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-2255
DR. MICHAEL JOSEPH MCCORMACK JR. M.D.
Internal Medicine (Hematology & Oncology)
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-2255
RANDALL STEPHAN CONRAD MD
Hospitalist
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4305
NICHOLAS RYAN TUTTLE CRNA
Nurse Anesthetist, Certified Registered
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 409-1797
DR. ANALICIA MARIE ALVARADO MD
Internal Medicine (Nephrology)
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-2255

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 Justin Lackey's NPI number?

The NPI number for Justin Lackey is 1497333512. It was assigned to this individual provider in the NPPES registry on March 30, 2021.

Where is Justin Lackey located?

Justin Lackey practices at Medical Center Blvd, Winston Salem, NC 27157. The listed phone number is (336) 716-7246.

What is Justin Lackey's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Justin Lackey enrolled in Medicare?

Yes. Justin Lackey is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Justin Lackey was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days 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.