PAYTON HUNTER LACK (AUD) – Audiologist, NPI 1043901390

PAYTON HUNTER LACK (AUD) is a healthcare provider. based in Greensboro, Georgia. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials AUD. They hold a License No. AUD004368 (GA). The NPI Number for PAYTON HUNTER LACK (AUD) is 1043901390

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
PAYTON HUNTER LACK (AUD)
NPI
1043901390
Phone
(706) 623-4425
Address
1051 PARKSIDE CMNS STE 103
Enumeration Date
17 May 2023
Last Update Date
17 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7707268948
Graduation Year
2022 (4 years ago)
PAC ID
0446602908
Group Practice PAC ID
2062654437
Professional Enrollment ID
I20240119002536
Address ID
GA301883758WO280XXWALK301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

263 QUALIFIED AUDIOLOGIST in GA

Provider Addresses for PAYTON HUNTER LACK (AUD)

  • 1051 PARKSIDE CMNS STE 103

    GREENSBORO, GA 306424517

    Phone: (706) 623-4425

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-01-19

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240119002536IQualified AudiologistGATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30642)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062654437View full group profile

Reviews

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Frequently asked questions

How do I look up PAYTON HUNTER LACK (AUD) by NPI?
Use NPI 1043901390 when you need to reference PAYTON HUNTER LACK (AUD) in forms, claims, or directories.
Is PAYTON HUNTER LACK (AUD) active in the national directory?
PAYTON HUNTER LACK (AUD)'s public NPI profile is in an active state.
What does PAYTON HUNTER LACK (AUD) treat or focus on?
Patients typically see PAYTON HUNTER LACK (AUD) under the specialty Audiologist. Clinical services aligned with this taxonomy classification.
What location shows for PAYTON HUNTER LACK (AUD)?
We surface Greensboro, Georgia for PAYTON HUNTER LACK (AUD) based on available NPPES addresses.
What if Greensboro, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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