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

Mrs. Lacey Dively Moy, MD

Individual provider Family Medicine Physician · NPI 1013144021

Mrs. Lacey Dively Moy, MD is a Family Practice in Springfield, Illinois. Graduated from Rush Medical College of Rush University in 2009, 17 years ago. Practices with Memorial Physician Services, a 158-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
17
Trained at
Rush Medical College of Rush University
Licensed in
IL
In the registry since
2009
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3220 Atlanta St
Springfield, IL 62707-8801
Phone: (217) 588-7400
Fax: (217) 588-7439
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036129248 (IL)

Record details

NPI number1013144021
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 17, 2009
Last updated in NPPESMay 16, 2023
Certification dateMay 16, 2023
Mailing address3220 Atlanta St, Springfield, IL 62707-8801

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolRUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduated 2009 (17 years in practice)
Group practice Memorial Physician Services — 158 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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