Jacob Gray Lackey, PA-C
Physician Assistant · Clemmons, NC
Jacob Gray Lackey, PA-C is a physician assistant with a practice address in Clemmons, North Carolina, and NPI 1699178731, issued on Oct 3, 2014. Check the license (North Carolina 0010-05288, as entered in NPPES) with the North Carolina board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Jacob Gray Lackey
- Credential
- PA-C
- Primary taxonomy
- Physician Assistant 363A00000X
- License numbers
- 0010-05288 NC
001005288 NC
Self-reported in NPPES; status is on the state search - Practice location
- 3163 Gammon LN, Clemmons, NC 27012
- Phone
- (336) 310-5571
- Enumerated
- Oct 3, 2014
- Record last updated
- Aug 18, 2021 (not updated in 5 years: call before relying on the address or phone)
- Fax
- (336) 310-5574
- Medicare enrollment
- Enrolled (PECOS I20150115002445); accepts Medicare assignment
- Entity
- Type 1 · individual
8 nearest physician assistant records → All 9,279 in North Carolina → Look up another NPI →
Also registered at 3163 Gammon LN
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Joshua Fleming, DNP-FNPNurse Practitioner1134737265
- Andrea Underwood, DNP, FNP-CNurse Practitioner1992019566
Verify Jacob Gray Lackey in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich North Carolina board licenses this profession
Search for license 0010-05288Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
66% fewer Medicare Part D claims than the average physician assistant in 2024
283 Medicare Part D claims for 184 beneficiaries, against an average of 830 among the 101,058 providers of this specialty who prescribed in Part D. 39 claims were for opioids.
Most prescribed
- Meloxicam139 claims
- Celecoxib28 claims
- Prednisone26 claims
- Tramadol Hcl20 claims
- Methocarbamol11 claims
Source: CMS Medicare Part D Prescribers by Provider and Drug, 2024 (data.cms.gov). Part D covers prescriptions for Medicare patients only; drugs with fewer than 11 claims are not published.
Industry payments in 2024: $140.44
7 payments; by number, the most common kind was food and beverage; the largest payer was Pacira Pharmaceuticals Incorporated. The 64,719 providers of this specialty with any payment received $841.65 on average. Payments are reported by manufacturers, not by the provider, and are not a sign of wrongdoing.
Source: CMS Open Payments, program year 2024 (openpaymentsdata.cms.gov); average among providers of this specialty with at least one payment.
Bills Medicare through one group practice
- Appalachian Regional Medical Associates IncBoone, NC
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Jacob Gray Lackey among 9,279 physician assistant records in North Carolina
Jacob Gray Lackey, PA-C is one of 9,279 physician assistant records with a practice address in North Carolina. 81% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2014, is newer than 41% of them.
- NPI issued2014 · 41% of these records are older, 55% newer
- In a Medicare fileYes · 81% of these records are
- In the CMS Doctors and Clinicians fileYes · 69% of these records are
- Graduated2014 · median 2017 among the 6,366 with a school on file
- Record last updated2021 · 35% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 363A00000X and a North Carolina practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
43 physician assistant records list a practice address in Clemmons
They are 43 of the 444 NPPES records with a practice address in Clemmons, and 9,279 physician assistant records in North Carolina.
All 9,279 in North Carolina → Every provider in Clemmons → Physician Assistant nationwide →
The 8 physician assistant records with the nearest ZIP codes
- Angela Acevedo, PAClemmons, NC 270121528155058
- Kenneth Bush, PAClemmons, NC 270121528020682
- Danielle Carter Adkins, PA-CClemmons, NC 270121992787501
- Glen Combs, P.A.Clemmons, NC 270121235102211
- Paul Davis, PA-CClemmons, NC 270121750384343
- Terry Deakle, PAClemmons, NC 270121326028382
- Mary Deakle, PA-CClemmons, NC 270121992762538
- Catherine Goodyear, P.A.-CClemmons, NC 270121720013543
Common questions
What is Jacob Gray Lackey, PA-C's NPI number?
Jacob Gray Lackey, PA-C's National Provider Identifier (NPI) is 1699178731, issued on Oct 3, 2014. An NPI identifies a provider in billing; it is not a license.
Where is Jacob Gray Lackey, PA-C located?
The NPPES record lists a practice address at 3163 Gammon LN, Clemmons, NC, 27012. Phone: (336) 310-5571. Providers update this record themselves, so call before visiting.
How can I verify Jacob Gray Lackey, PA-C's license?
NPPES lists North Carolina license number 0010-05288, as entered by the provider. Search the North Carolina board that licenses this profession; the NPPES record confirms identity only.
How much does Jacob Gray Lackey, PA-C prescribe under Medicare Part D?
In 2024, Jacob Gray Lackey, PA-C had 283 Medicare Part D claims for 184 beneficiaries; the average among physician assistant prescribers was 830. Part D covers Medicare prescriptions only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.