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JUSTIN TREVOR LACKEY MD
NPI 1497333512
Internal Medicine - Critical Care Medicine in Winston Salem, NC

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

NPPES record last updated: October 3, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Oct 3, 2024, Jul 9, 2024, Mar 30, 2021 (3 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 critical care medicine provider in Winston Salem, North Carolina, licensed in North Carolina (317799) 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 Taxonomy207RC0200X
Provider Legal NameJUSTIN TREVOR LACKEYCredential: MD
Location AddressONE MEDICAL CENTER BLVDWinston Salem, NC 27157-3465
Mailing AddressOne Medical 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 UpdateOctober 3, 20243 updates tracked since enumeration
NPPES CertifiedOctober 3, 2024
✔ NPI 1497333512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
License✔ Licensed in NC · 317799
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 0101281117 (VA)
ONE MEDICAL CENTER BLVD, Winston Salem, NC 27157
Open in Google Maps ↗

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27157 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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 20

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

ANNA LARUSSA MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (855) 799-0044
DR. JARED JOSEPH TUTTLE MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4091
CESAR ANDRES URIZAR-GONZALEZ MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 713-7527
HOLDEN BRADLY LEWIS
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-7580
HONGSHENG LU MD
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 713-7527
RAED WALEED ALI ALKHADDASH
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-7548
PEMBROKE NASH III
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-2011
IAN ALASDAIR SEDDON DO
Student in an Organized Health Care Education/Training Program
ONE MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Forsyth County (336) 716-4490

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 One 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 Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

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 October 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.