Lacey Deshay Kennon, APRN, FNP-C - Medicare Nurse Practitioner in Fort Smith, AR

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Lacey Deshay Kennon, APRN, FNP-C is a medicare enrolled "Orthopaedic Surgery" in Fort Smith, Arkansas. She went to University Of South Alabama College Of Medicine and graduated in 2020 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Fands Physical Therapy, Inc, Baptist Health Services, Mercy Clinic Fort Smith Communities and her current practice location is 3501 We Knight Dr, Fort Smith, Arkansas. You can reach out to her office (for appointments etc.) via phone at (479) 414-9629.

Lacey Deshay Kennon is licensed to practice in Arkansas (license number 212497) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1861018350.

Contact Information

Lacey Deshay Kennon, APRN, FNP-C
3501 We Knight Dr,
Fort Smith, AR 72903-6254
(479) 414-9629
Not Available

Map and Direction




Provider's Profile

Full NameLacey Deshay Kennon
GenderFemale
SpecialityNurse Practitioner
Experience6 Years
Location3501 We Knight Dr, Fort Smith, Arkansas
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Lacey Deshay Kennon attended and graduated from University Of South Alabama College Of Medicine in 2020
  NPI Data:
  • NPI Number: 1861018350
  • Provider Enumeration Date: 06/19/2020
  • Last Update Date: 07/31/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 0042637530
  • Enrollment ID: I20200828001816

Medical Identifiers

Medical identifiers for Lacey Deshay Kennon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1861018350NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family F06201581 (Arkansas)Secondary
207X00000XOrthopaedic Surgery 212497 (Arkansas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Elite Home HealthFort smith, ARHome health agency
Baptist Health - Fort SmithFort smith, ARHospital
Baptist Health - Van BurenVan buren, ARHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Fands Physical Therapy, Inc7810898459217
Baptist Health Services0648514133103
Mercy Clinic Fort Smith Communities3870668510361

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 Deshay Kennon allows following entities to bill medicare on her behalf.
Entity NamePrime Physicians LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033454723
PECOS PAC ID: 4183878176
Enrollment ID: O20130128000344
Entity NameBaptist Health Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922587690
PECOS PAC ID: 0648514133
Enrollment ID: O20181211001401

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 Deshay Kennon 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 AddressPractice Location Address
Lacey Deshay Kennon, APRN, FNP-C
3501 We Knight Dr,
Fort Smith, AR 72903-6254

Ph: (479) 709-6700		Lacey Deshay Kennon, APRN, FNP-C
3501 We Knight Dr,
Fort Smith, AR 72903-6254

Ph: (479) 414-9629

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.