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KIMBERLY J LACKEY M.ED.
NPI 1619142973
Counselor - School in Ronda, NC

Active since April 28, 2008PECOS Enrolled
360 RIVERBOTTOM RD, RONDA, NC 28670(828) 850-5107 Get Directions Write a Review

NPPES record last updated: August 3, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Kimberly J Lackey M.ed. NPPES

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

KIMBERLY J LACKEY M.ED. (NPI 1619142973) is an individual school provider in Ronda, North Carolina and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS and maintains a secondary practice location in Hudson.

NPPES Registry Identity

NPI1619142973
Entity TypeIndividualFemale
Primary Taxonomy101YS0200X
Provider Legal NameKIMBERLY J LACKEYCredential: M.ED.
Location Address360 RIVERBOTTOM RDRonda, NC 28670-9300
Mailing Address360 Riverbottom RdRonda, NC 28670-9300 · (828) 850-5107
Phone(828) 850-5107
Sole ProprietorYes
Enumeration DateApril 28, 2008
Last NPPES UpdateAugust 3, 2022
NPPES CertifiedAugust 3, 2022
✔ NPI 1619142973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · SchoolBehavioral Health & Social Service Providers
Taxonomy Code101YS0200X
360 RIVERBOTTOM RD, Ronda, NC 28670
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Secondary Practice Location 1

Location 12855 Hickory BlvdHudson, NC 28638-2672 · Phone (828) 726-2301

Other Identifiers 1

Other4877NC · Nclpc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Plan of North Carolina, Inc, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly J Lackey M.ed. 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.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Lackey reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PA
722 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, North Carolina enrollment
  • 712 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Kimberly Lackey's NPI number?

The NPI number for Kimberly Lackey is 1619142973. It was assigned to this individual provider in the NPPES registry on April 28, 2008.

Where is Kimberly Lackey located?

Kimberly Lackey practices at 360 Riverbottom Rd, Ronda, NC 28670. The listed phone number is (828) 850-5107.

What is Kimberly Lackey's specialty?

The primary specialty registered for this NPI is Counselor, specializing in School, with taxonomy code 101YS0200X.

Is Kimberly Lackey enrolled in Medicare?

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

Which organization bills Medicare for Kimberly Lackey's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Lackey reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). The 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 Kimberly Lackey's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimberly Lackey accept?

Health plans from Oscar Health Plan of North Carolina, Inc and UnitedHealthcare list Kimberly Lackey 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 Kimberly Lackey was last updated on August 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.