DR. LOGAN B LACKEY II M.D.
NPI 1740506419
Radiology - Diagnostic Radiology in Springfield, MO

Active since April 20, 2010PECOS EnrolledAccepts Medicare Assignment
2055 S FREMONT AVE, SUITE 120, SPRINGFIELD, MO 65804(417) 820-2500 Get Directions Write a Review

NPPES record last updated: July 5, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Logan B Lackey Ii M.d. NPPES

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

DR. LOGAN B LACKEY II M.D. (NPI 1740506419) is an individual diagnostic radiology provider in Springfield, Missouri, licensed in Missouri (2016020760) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS, is affiliated with Blessing Hospital, and is a graduate of Northeastern Ohio University College Of Medicine (2010).

NPPES Registry Identity

NPI1740506419
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDR. LOGAN B LACKEY IICredential: M.D.
Location Address2055 S FREMONT AVE, SUITE 120Springfield, MO 65804-2206
Mailing Address2055 S Fremont Ave, Suite 120Springfield, MO 65804-2206 · (417) 820-2500
Sole ProprietorYes
Medical School CMSNortheastern Ohio University College Of MedicineGraduated 2010
Enumeration DateApril 20, 2010
Last NPPES UpdateJuly 5, 2016
NPI 1740506419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License Licensed in MO · 2016020760
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
2055 S FREMONT AVE, Springfield, MO 65804

Accepted 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

Dr. Logan B Lackey Ii M.d. 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 ID6901198639
PECOS Enrollment IDI20160715001579, I20230613003433
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 11

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.

Screening mammography 77067
Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.
676 services676 patients
Screening 3d breast mammography 77063
Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.
622 services622 patients
Screening mammography 77067
Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.
104 services104 patients
Screening 3d breast mammography 77063
Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.
102 services102 patients
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) G0279
Diagnostic digital breast tomosynthesis is a 3D imaging test that allows doctors to examine your breast tissue layer by layer. It's performed on one or both sides. It helps in detecting abnormalities more accurately. It's often done in addition to other tests.
85 services83 patients
Diagnostic mammography of 1 breast 77065
Diagnostic mammography of 1 breast is a detailed imaging test that allows doctors to closely examine a specific area in the breast. It's often used when a routine screening reveals an abnormality. This test can help identify any unusual changes or issues.
73 services67 patients

Hospital Affiliations CMS Care Compare 2

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

Blessing Hospital

Acute Care Hospitals · Quincy, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140015
Location1005 Broadway StQuincy, IL 62301 · Adams County
Emergency services Birthing friendly

Illini Community Hospital

Critical Access Hospitals · Pittsfield, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141315
Location640 W WashingtonPittsfield, IL 62363 · Pike County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65804 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
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$65.71 typical visit price
range $16.30 – $131.05
Typical copayment $16.42 (range $4.07 – $32.76)
Most-billed visit code 99213
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.

Radiology (Radiation Oncology)
2055 S FREMONT AVE
SPRINGFIELD, MO 65804
Nurse Practitioner (Family)
2055 S FREMONT AVE
SPRINGFIELD, MO 65804
Nurse Practitioner (Family)
2055 S FREMONT AVE, STE 200
SPRINGFIELD, MO 65804
Internal Medicine (Hematology & Oncology)
2055 S FREMONT AVE
SPRINGFIELD, MO 65804
Nurse Practitioner (Family)
2055 S FREMONT AVE
SPRINGFIELD, MO 65804
Nurse Practitioner (Family)
2055 S FREMONT AVE
SPRINGFIELD, MO 65804
Internal Medicine (Hematology & Oncology)
2055 S FREMONT AVE, SUITE 100
SPRINGFIELD, MO 65804
Obstetrics & Gynecology (Gynecologic Oncology)
2055 S FREMONT AVE, STE 200
SPRINGFIELD, MO 65804

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 Logan Lackey's NPI number?

The NPI number for Logan Lackey is 1740506419. It was assigned to this individual provider in the NPPES registry on April 20, 2010.

Where is Logan Lackey located?

Logan Lackey practices at 2055 S Fremont Ave Suite 120, Springfield, MO 65804. The listed phone number is (417) 820-2500.

What is Logan Lackey's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Logan Lackey enrolled in Medicare?

Yes. Logan Lackey 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 Logan Lackey accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 6 other insurers list Logan 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.

Is Logan Lackey affiliated with any hospitals?

According to CMS data, Logan Lackey is affiliated with Blessing Hospital and Illini Community Hospital.

When was this NPI record last updated?

The NPPES record for Logan Lackey was last updated on July 5, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.