Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Taylor Lackey

Individual provider Nurse Practitioner · NPI 1083479539

Taylor Lackey is a Nurse Practitioner in Menasha, Wisconsin. Qualified in 2024, 2 years ago. Practices with Thedacare, Incorporated, a 654-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
2
Licensed in
WI
In the registry since
2024
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1095 Midway Rd
Menasha, WI 54952-1115
Phone: (920) 720-2300
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 15030 (WI)
Nurse Practitioner Taxonomy 363L00000X · Licence 15030 (WI)

Record details

NPI number1083479539
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 14, 2024
Last updated in NPPESNovember 6, 2025
Certification dateNovember 6, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Thedacare, Incorporated — 654 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients12
Services billed 73 a service is one billed item, such as a visit, a test or a procedure
Average patient age58

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Thedacare, Incorporated

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 654 clinicians in the practice; 12 are shown here.

Other providers in Menasha