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

Lacey Moody

Individual provider Physical Therapist · NPI 1083025001

Lacey Moody is a Physical Therapist in Private Practice in Southaven, Mississippi. Qualified in 2013, 13 years ago. Practices with Aegis Group Practice LLC, a 406-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Mississippi.

Years since qualifying
13
Licensed in
MS
In the registry since
2014
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Practice location Address checks out

3964 Goodman Rd E Ste 111
Southaven, MS 38672-8761
Phone: (662) 890-6953
Fax: (662) 890-6954
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT5426 (MS)

Record details

NPI number1083025001
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 13, 2014
Last updated in NPPESMay 13, 2014

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Aegis Group Practice Llc — 406 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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