LACY DANIELLE GULLEDGE ARNP
NPI 1609387174
Nurse Practitioner - Gerontology in Jacksonville, FL
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
Specialties & Licenses 2
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
2Medicare enrollment records show Lacy Gulledge reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Yulee, FL 32097
- Reassigned Medicare billing, Florida enrollment
- Also billed through NPI 1104086479 (Florida)
- 573 clinicians in this Medicare group
Oklahoma City, OK 73134
- Reassigned Medicare billing, Oklahoma enrollment
- 1,058 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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, OKPhysician 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.
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.
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.
JACKSONVILLE, FL 32218
JACKSONVILLE, FL 32218
JACKSONVILLE, FL 32218
JACKSONVILLE, FL 32218
JACKSONVILLE, FL 32218
JACKSONVILLE, FL 32218
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.
Which organizations bill Medicare for Lacy Gulledge's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lacy Gulledge reassigns Medicare benefits to 2 organizations: University Of Florida Jacksonville Physicians Inc (Yulee, FL) and Integris Ambulatory Care Corporation (Oklahoma City, OK). 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 Lacy Gulledge's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Lacy Gulledge accept?
Health plans from Blue Cross and Blue Shield of Oklahoma 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.
# Lacy Danielle Gulledge, ARNP · NPI 1609387174
Gerontology physician in Jacksonville, Florida. Individual provider, active in the CMS NPPES registry since October 23, 2017.
## Identity
- **NPI:** 1609387174 (Entity type: Individual)
- **Enumerated:** October 23, 2017
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** ARNP9429348 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 15255 MAX LEGGETT PKWY, Jacksonville, FL 32218-7273
- **Phone:** (904) 244-0411
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): University Of Florida Jacksonville Physicians Inc (NPI 1740836048, Yulee, FL); Integris Ambulatory Care Corporation (NPI 1750333936, Oklahoma City, OK) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** January 30, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1609387174) · Data from the CMS NPPES public registry.