LACEY MCCRARY – Primary Care Nurse Practitioner, NPI 1669769477

LACEY MCCRARY is a healthcare provider. based in Shawnee, Oklahoma. specializing in Primary Care Nurse Practitioner. They hold a License No. 89833 (OK). The NPI Number for LACEY MCCRARY is 1669769477

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
LACEY MCCRARY
NPI
1669769477
Phone
(405) 273-5236
Address
2307 GORDON COOPER DR
Enumeration Date
30 June 2011
Last Update Date
13 December 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4056922118
Graduation Year
2011 (15 years ago)
PAC ID
0446421234
Group Practice PAC ID
4183856784
Professional Enrollment ID
I20110928000302
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for LACEY MCCRARY

  • 2307 GORDON COOPER DR

    SHAWNEE, OK 748019007

    Phone: (405) 273-5236

    Fax: (405) 818-4690

    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)

CMS reports 14 Open Payments records for all available years, with a total value of $299.

Total Amount is formed as General ($299) + Research ($0) + Ownership ($0) = $299.

Last reported payment date: 2024-12-03 • Largest payer in this snapshot: ABBVIE INC. ($193).

Total Amount

$299

General + Research + Ownership

Payments

14

Total payment records

General Amount

$299

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-03

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2011-09-28

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
I20110928000302INurse PractitionerOKTBD

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 74801)

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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: 4183856784View full group profile
NameSpecialtyState
Nurse PractitionerOK
Nurse PractitionerOK
Family PracticeOK
Nurse PractitionerOK

Reviews

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Frequently asked questions

Can I use this page to confirm LACEY MCCRARY's NPI?
Yes. LACEY MCCRARY is listed with NPI 1669769477 in the public NPI dataset.
Does CMS list LACEY MCCRARY as active?
Yes — LACEY MCCRARY is active in the NPI listing used on this page.
What is LACEY MCCRARY best known for clinically?
Directory data describes LACEY MCCRARY with Primary Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does LACEY MCCRARY list a practice location?
Patients near Shawnee, Oklahoma may find LACEY MCCRARY in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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