NPI age
19 years
Enumerated 2006-06-15
● Active
Type 1 · Individual
John Lackey, MD
Lackey is 1 of 13 specialist providers in Pocatello and 1 of 305 in Idaho.
Primary specialty
Specialist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2007-07-08
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 305 active specialist providers in Idaho.
NPI age
19 years
≈ at median (18 yr)
State licenses
1 state
2% of peers hold multiple states
Subspecialties
0
11% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-06Enumerated in NPPES
2006
2026
Where they practice
Practice location
500 S 11th Ave
Pocatello, ID 832014835
Mailing address
700 Canyon Dr
Pocatello, ID 832044840
Specialties
-
Specialist PrimaryAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002487500 |
Practice context
Part of a multi-provider practice. 36 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.