LACY DANIELLE GULLEDGE ARNP
NPI 1609387174
Nurse Practitioner - Gerontology in Jacksonville, FL

Q: What is Lacy Gulledge's NPI number?

The NPI number for Lacy Gulledge is 1609387174. It was assigned to this individual provider in the NPPES registry on October 23, 2017. The provider is also known as Lacy Wade.

Q: What is Lacy Gulledge's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Lacy Gulledge was last updated on January 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since October 23, 2017PECOS EnrolledAccepts Medicare Assignment

81.9/100

CMS Quality Rating

15255 MAX LEGGETT PKWY, JACKSONVILLE, FL 32218(904) 244-0411 Get Directions Write a Review

NPPES record last updated: January 30, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Lacy Danielle Gulledge Arnp NPPES

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

LACY DANIELLE GULLEDGE ARNP (NPI 1609387174) is an individual gerontology provider in Jacksonville, Florida, licensed in Florida (ARNP9429348) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS, is affiliated with Integris Baptist Medical Center, Inc, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1609387174

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameLACY DANIELLE GULLEDGECredential: ARNP

Location Address15255 MAX LEGGETT PKWYJacksonville, FL 32218-7273

Mailing Address75338 Ravenwood DrYulee, FL 32097-1609 · (334) 208-6190

Phone(904) 244-0411

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateOctober 23, 2017

Last NPPES UpdateJanuary 30, 2018

✔ NPI 1609387174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in FL · ARNP9429348

Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License ARNP9429348 (FL)

15255 MAX LEGGETT PKWY, Jacksonville, FL 32218

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Other Names 1

Former Name (1)Lacy Wade

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Medica.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lacy Danielle Gulledge Arnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941560049

PECOS Enrollment IDI20250123000694

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

27 services27 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

20 services20 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

17 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Integris Baptist Medical Center, Inc

Acute Care Hospitals · Oklahoma City, OK

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370028

Location3300 Northwest ExpresswayOklahoma City, OK 73112 · Oklahoma County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32218 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.9/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

72.43

Promoting Interoperability

100

Improvement Activities

Cost

59.59

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.

TRANSCENDENT MULTISERVICE ASSIST, LLC

Registered Nurse (Registered Nurse First Assistant)

15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218

Duval County (904) 382-1987

DR. SUDHA RANI MUTYALA MD

Student in an Organized Health Care Education/Training Program

15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218

Duval County (904) 383-1000

MARK A LIVECCHI MD

Physical Medicine & Rehabilitation (Brain Injury Medicine)

15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218

Duval County (904) 456-8297

SHEILA COMPTON LCSW

Social Worker (Clinical)

15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218

Duval County (904) 383-1000

SOUTHEAST ORTHOPEDIC SPECIALISTS, INC

Non-Pharmacy Dispensing Site

15255 MAX LEGGETT PKWY, 5TH FLOOR
JACKSONVILLE, FL 32218

Duval County (727) 755-0693

ALFONSO DAVID MORENO GUTIERREZ M.D

Hospitalist

15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218

Duval County (773) 349-5197

DR. ERIN THOR WOLFF M.D.

Physical Medicine & Rehabilitation

15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218

Duval County (904) 456-8001

SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC

Specialist

15255 MAX LEGGETT PKWY, 5TH FLOOR
JACKSONVILLE, FL 32218

Duval County (904) 634-0640

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 Lacy Gulledge's NPI number?

The NPI number for Lacy Gulledge is 1609387174. It was assigned to this individual provider in the NPPES registry on October 23, 2017. The provider is also known as Lacy Wade.

Where is Lacy Gulledge located?

Lacy Gulledge practices at 15255 Max Leggett Pkwy, Jacksonville, FL 32218. The listed phone number is (904) 244-0411.

What is Lacy Gulledge's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Lacy Gulledge enrolled in Medicare?

Yes. Lacy Gulledge is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lacy Gulledge accept?

Health plans from AvMed and Medica list Lacy Gulledge 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.

Is Lacy Gulledge affiliated with any hospitals?

According to CMS data, Lacy Gulledge is affiliated with Integris Baptist Medical Center, Inc.

When was this NPI record last updated?

The NPPES record for Lacy Gulledge was last updated on January 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.