Lane Marie Bryant, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.0003983 Issued in CO

Practice address

1860 E Egbert St
Brighton, CO 80601-2475

Phone

(303) 659-4000

Fax

(303) 659-9306

NPI assigned

Jul 18, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lane Marie Erickson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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

• Colorado State University

  • Clinic/Center
  • Fort Collins, CO
  • NPI 1528156437
  NPD (past)

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1013324367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ROLLIE AVE",
            "address_2": "BILLING DEPT - CREDENTIALIST",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211508",
            "telephone_number": "303-286-4560",
            "fax_number": "303-286-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 E EGBERT ST",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012475",
            "telephone_number": "303-659-4000",
            "fax_number": "303-659-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "LANE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0003983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96781386",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LANE",
            "last_name": "ERICKSON",
            "middle_name": "MARIE",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Brooks, CCC-SLP
• Adam C Brown, O.D.
• Amy J Brown
• Laura Elizabeth Brown
• Lisa Brown, CMT/LMT
• Buckeye C, LLC
• Buckeye C, LLC
• Buckeye C, LLC
• Buffalini Primary Care, LLC
• Michelle Buffalini, CRNP

• All providers in Brighton, CO
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.