Lacey Waddell, MS, RD, LD is a medicare enrolled "Dietitian, Registered" provider in Sundance, Wyoming. Her current practice location is
713 W Oak Street, Sundance, Wyoming. You can reach out to her office (for appointments etc.) via phone at
(307) 283-3501.
Lacey Waddell is licensed to practice in Wyoming (license number 211) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1033497425.
Healthcare Provider's Profile
| Full Name | Lacey Waddell |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 713 W Oak Street, Sundance, Wyoming |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1033497425
- Provider Enumeration Date: 08/02/2011
- Last Update Date: 12/20/2018
Medicare PECOS Information:
- PECOS PAC ID: 0143491134
- Enrollment ID: I20110923000195
Medical Identifiers
Medical identifiers for Lacey Waddell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1033497425 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 0410 (South Dakota) | Secondary |
| 133V00000X | Dietitian, Registered | 211 (Wyoming) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lacey Waddell allows following entities to bill medicare on her behalf.
| Provider Name | Monument Health Network Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1588185268
PECOS PAC ID: 5991616427
Enrollment ID: O20031111000854 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lacey Waddell is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Lacey Waddell, MS, RD, LD
Po Box 517,
Sundance, WY 82729-0517
Ph: (307) 283-3501 | Lacey Waddell, MS, RD, LD
713 W Oak Street,
Sundance, WY 82729
Ph: (307) 283-3501 |
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