Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shanon Renee Lacy, DO

Individual provider Dermatopathology (Pathology) Physician · NPI 1003076142

Dr. Shanon Renee Lacy, DO is a Pathology in West Allis, Wisconsin. Graduated from Chicago College of Medicine and Surgery in 2007, 19 years ago. Practices with Great Lakes Pathologists SC, a 55-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
19
Trained at
Chicago College of Medicine and Surgery
Licensed in
WI
In the registry since
2008
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone: (414) 328-7675
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 56999-21 (WI)
Dermatopathology (Pathology) Physician Taxonomy 207ZD0900X · Licence 56999-21 (WI)

Record details

NPI number1003076142
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 12, 2008
Last updated in NPPESDecember 30, 2021
Certification dateDecember 30, 2021
Mailing address102 N Water St Unit 206, Milwaukee, WI 53202-6056

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolCHICAGO COLLEGE OF MEDICINE AND SURGERY
Graduated 2007 (19 years in practice)
Group practice Great Lakes Pathologists Sc — 55 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

Other providers in West Allis