John Lackey, Inc
John Lackey, Inc is a healthcare organization registered as Eyewear Supplier in Summersville, WV, holding Type 2 (organization) NPI 1609904663 since 2007. The authorized official on file is John Lackey, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1609904663 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | John Lackey, Inc |
| Other name | <Unavail> |
| Practice address | 702 PROFESSIONAL PARK DR, SUITE102, Summersville, WV, 26651 |
| Phone | 3048726433 |
| Fax | 3048726562 |
| Enumeration date | 2007-03-01 |
| Last updated in NPPES | 2011-11-03 |
Authorized official
| Name | John Lackey |
|---|---|
| Title | Owner |
| Phone | 3048726433 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier | Primary | 736 | WV |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205951605 | Other | WV | MEDICARE GROUP PAYER NPI (MEDICAL PRACTICE) |
| 1609904663 | Other | WV | DME SUPPLIER NPI |
| 00094926001 | Other | WV | MEDICAID OPTICAL SUPPLIER NUMBER |
| 0257640001 | Other | WV | MEDICARE DME PTAN (SUPPLIER PTAN) |
Copy-ready billing details
Provider: John Lackey, Inc NPI: 1609904663 Taxonomy: 332H00000X (Eyewear Supplier) Address: 702 PROFESSIONAL PARK DR, SUITE102, Summersville, WV, 26651
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1023122041 | Robert Stanley | Individual | Family Medicine Physician | Summersville, WV |
| 1205951605 | Dr John Lackey Inc | Organization | Ophthalmology Physician | Summersville, WV |
Verify this record
Cross-check NPI 1609904663 against the authoritative CMS record: view John Lackey, Inc on the official NPPES registry .
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. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for John Lackey, Inc?
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Source: CMS NPPES (public data). Snapshot 2026-07-09. Provider record last updated 2011-11-03.