Individual provider Active NPI

Karen Lane, ANP-BC

  • Adult Health Nurse Practitioner
  • Blue Ash, OH
National Provider Identifier
1003155722
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
14240 Issued in OH
Practice address
4243 Hunt Rd
Blue Ash, OH 45242-6645
Phone
(513) 535-5567
NPI assigned
Feb 1, 2013
Last updated
May 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 14240 OH Primary

Addresses

Primary practice location

4243 Hunt Rd
Blue Ash, OH 45242-6645

Mailing address

4243 Hunt Rd
Blue Ash, OH 45242-6645
Phone (513) 712-0604

Other identifiers 1

IdentifierTypeStateIssuer
0100271MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140425000475 OH Practitioner - Nurse Practitioner 7113150228 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Wound Healing LLCGroup PAC ID 6204275514, 8 clinicians

Practice addresses (Care Compare)

6371 Riverside Dr
Suite 1100
Dublin, OH 43017-5446
Phone (614) 516-6980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14240OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healogics Specialty Physicians of Ohio, LLC CurrentSince Apr 26, 2016 Accepting new patients
ND Health Associates CurrentSince Mar 24, 2024 Accepting new patients
Mobile Wound Healing LLC CurrentSince Sep 19, 2024 Accepting new patients

Locations

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256
Phone (904) 446-3686

1792 State Route 125
Amelia, OH 45102
Phone (513) 247-6161

4243 Hunt Rd
Blue Ash, OH 45242
Phone (513) 791-8038

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

375 Dixmyth Ave
Fl 15
Cincinnati, OH 45220
Phone (513) 487-4100

6371 Riverside Dr
Ste 1100
Dublin, OH 43017
Phone (614) 516-6980

6375 Riverside Dr
Ste 105
Dublin, OH 43017
Phone (614) 516-6980

1010 Cereal Ave
Hamilton, OH 45013
Phone (513) 281-8827

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1003155722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4243 HUNT RD",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452426645",
            "telephone_number": "513-712-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4243 HUNT RD",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452426645",
            "telephone_number": "513-535-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "KAREN",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-01",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "14240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0100271",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ash, OH

Sources for this page

Verify at the official NPI Registry.