MR. JAMES DYLAN LACKEY (FNP-BC) – Family Nurse Practitioner, NPI 1205403151
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
Provider Addresses for MR. JAMES DYLAN LACKEY (FNP-BC)
6255 W SUNSET BLVD FL 21
LOS ANGELES, CA 900287422
Phone: (323) 860-5200
Fax: (234) 677-1193
Type: Mailing
1438 W PEACHTREE ST NW
ATLANTA, GA 303092998
Phone: (470) 283-7349
Fax: (833) 689-2507
Type: Location
4940 GOVERNORS DR STE 209
FOREST PARK, GA 302972186
Phone: (770) 277-1290
Fax: (770) 277-0282
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $480.
Total Amount is formed as General ($480) + Research ($0) + Ownership ($0) = $480.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Theratechnologies Inc. ($264).
Total Amount
$480
General + Research + Ownership
Payments
15
Total payment records
General Amount
$480
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Theratechnologies Inc. | $264 |
| ViiV Healthcare Company | $165 |
| Janssen Scientific Affairs, LLC | $51 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-09-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210909002101 | I | Nurse Practitioner | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 18 | 13 | $0 |
Insurance plans in this area (ZIP 90028)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| Infectious Disease, Internal Medicine | CA | |
| - | FL | |
| - | SC | |
| Physician Assistant | CA | |
| Family Practice | SC | |
| - | FL | |
| P S Y C H I A T R Y | FL | |
| - | FL | |
| Internal Medicine | CA |
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