DR. KIM B LACKEY DNP, APRN, AGPCNP-BC
NPI 1699241752
Nurse Practitioner - Primary Care in Matthews, NC

Q: What is Kim Lackey's NPI number?

The NPI number for Kim Lackey is 1699241752. It was assigned to this individual provider in the NPPES registry on October 16, 2018.

Q: What is Kim Lackey's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Kim Lackey was last updated on February 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since October 16, 2018PECOS Enrolled

434 N TRADE ST STE 104, MATTHEWS, NC 28105(704) 246-3936(704) 771-1931 Get Directions Write a Review

NPPES record last updated: February 26, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 22, 2020, Oct 16, 2018 (2 updates tracked since 2018).

On this page

About Dr. Kim B Lackey Dnp, Aprn, Agpcnp-bc NPPES

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

DR. KIM B LACKEY DNP, APRN, AGPCNP-BC (NPI 1699241752) is an individual primary care provider in Matthews, North Carolina, licensed in North Carolina (5011316) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1699241752

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameDR. KIM B LACKEYCredential: DNP, APRN, AGPCNP-BC

Location Address434 N TRADE ST STE 104Matthews, NC 28105-1865

Mailing Address434 N Trade St Ste 104Matthews, NC 28105-1865 · (704) 246-3936 · Fax (704) 771-1931

Phone(704) 246-3936

Fax(704) 771-1931

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateOctober 16, 2018

Last NPPES UpdateFebruary 26, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 26, 2026

✔ NPI 1699241752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

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

Taxonomy Code363LP2300X

License✔ Licensed in NC · 5011316

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 5011316 (NC)

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 5011316 (NC)

434 N TRADE ST STE 104, Matthews, NC 28105

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Insurance, Oscar Insurance Corporation of Ohio.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kim B Lackey Dnp, Aprn, Agpcnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8022599448

PECOS Enrollment IDI20260224003396

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 Reassignments

Medicare enrollment records show Kim Lackey reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Forsyth Medical Group, LLC

Same address

Internal Medicine

434 N TRADE ST STE 104
Matthews, NC 28105

Reassigned Medicare billing, North Carolina enrollment
52 clinicians in this Medicare group

NPI 1194538611 (704) 246-3936

Complexcare Medical Group Midwest M PLLC

529 mi

Internal Medicine

41800 W 11 MILE RD STE 109
Novi, MI 48375

Reassigned Medicare billing, North Carolina enrollment
41 clinicians in this Medicare group

NPI 1528851607 (248) 660-1220

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28105 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

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

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

FORSYTH MEDICAL GROUP, LLC

Internal Medicine

434 N TRADE ST STE 104
MATTHEWS, NC 28105

Mecklenburg County (704) 246-3936

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 Kim Lackey's NPI number?

The NPI number for Kim Lackey is 1699241752. It was assigned to this individual provider in the NPPES registry on October 16, 2018.

Where is Kim Lackey located?

Kim Lackey practices at 434 N Trade St Ste 104, Matthews, NC 28105. The listed phone number is (704) 246-3936.

What is Kim Lackey's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Kim Lackey enrolled in Medicare?

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

Which organizations bill Medicare for Kim Lackey's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kim Lackey reassigns Medicare benefits to 2 organizations: Forsyth Medical Group, LLC (Matthews, NC) and Complexcare Medical Group Midwest M PLLC (Novi, MI). 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 Kim Lackey's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kim Lackey accept?

Health plans from Oscar Health Insurance and Oscar Insurance Corporation of Ohio list Kim 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 Kim Lackey was last updated on February 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.