| Lacie Shae Burge, NP | |
|
400 South Oak Street, Randolph Medical Center, Winchester, IN 47394 | |
| (765) 584-6600 | |
| (765) 584-6503 |
| Full Name | Lacie Shae Burge |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 9 Years |
| Location | 400 South Oak Street, Winchester, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972043305 | NPI | - | NPPES |
| P02622733 | Other | IN | RAILROAD PTAN |
| 224040161 | Other | IN | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 71007164A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Indiana University Health Ball Memorial Hospital | Muncie, IN | Hospital |
| Indiana University Health | Indianapolis, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Indiana University Health Ball Memorial Physicians Inc | 9537072640 | 314 |
| Entity Name | Indiana University Health Ball Memorial Physicians Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235455544 PECOS PAC ID: 9537072640 Enrollment ID: O20031110000505 |
| Entity Name | Urology Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326093147 PECOS PAC ID: 5799876678 Enrollment ID: O20070807000354 |
| Entity Name | Reid Physician Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265689111 PECOS PAC ID: 6406910769 Enrollment ID: O20090130000573 |
| Mailing Address | Practice Location Address |
|---|---|
| Lacie Shae Burge, NP 1100 Reid Parkway, Medical Staff Services, Richmond, IN 47374 Ph: (765) 584-6600 | Lacie Shae Burge, NP 400 South Oak Street, Randolph Medical Center, Winchester, IN 47394 Ph: (765) 584-6600 |
Pauletta J Hummel, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 473 E Greenville Ave, Winchester, IN 47394 Phone: 765-584-0240 | |
Amanda K Clevenger, APRN-NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 409 E Greenville Ave, Winchester, IN 47394 Phone: 765-584-0480 | |
Mrs. Lisa Marcella Moore, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 409 Se Greenville Ave, Winchester, IN 47394 Phone: 765-584-0480 | |
Elizabeth Jade Davis, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 409 Se Greenville Ave, Winchester, IN 47394 Phone: 765-584-0480 Fax: 765-584-0470 | |
Kelly J Campbell, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 409 E Greenville Ave, Suite 300, Winchester, IN 47394 Phone: 765-584-0480 | |
Mrs. Heidi Marie Krauskopf, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 409 Se Greenville Ave, Winchester, IN 47394 Phone: 765-584-0480 | |
Alice Pauline Watkins, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 108 E Hospital Dr, Winchester, IN 47394 Phone: 765-584-1639 Fax: 765-584-4711 |