Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum
Jacob Gray Lackey, PA-C
Physician Assistant in Clemmons, NC · enumerated 2014.
Data current as of Jul 13, 2026 · sourced from CMS NPPES
National Provider Identifier
1699178731
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Registry record
Entity type Individual (Type 1)
Name Jacob Gray Lackey
Credential PA-C
Sex Male
Practice address 3163 Gammon Ln, Clemmons, NC, 27012
Phone (336) 310-5571
Fax (336) 310-5574
Enumeration date Oct 3, 2014
Last updated in NPPES Aug 18, 2021
Taxonomy & licenses
363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers · License 0010-05288 (NC) Primary
363AM0700X Medical Physician Assistant Physician Assistants & Advanced Practice Nursing Providers · License 001005288 (NC) Secondary
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.
Frequently asked questions
Is this the official NPI registry?
No. NPI Portal is a private site built on public CMS NPPES data. The official registry is npiregistry.cms.hhs.gov, operated by CMS.
What specialty is Jacob Lackey?
Jacob Lackey is registered in NPPES with the primary taxonomy of Physician Assistant. The taxonomy code describes the provider's classification and area of specialization for claims and credentialing.
Other providers at this practice address
Browse all →Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-08-18.