Individual provider Active NPI

Lanny Lee Monroe Jr., MD

  • Pediatrics Physician
  • Albemarle, NC
National Provider Identifier
1033156245
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
200600501 Issued in NC
Practice address
105 Yadkin St
Suite 303
Albemarle, NC 28001-3449
Phone
(704) 982-2683
Fax
(704) 512-4838
NPI assigned
May 31, 2006
Last updated
Nov 11, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2006-00501 NC
Pediatrics Physician 208000000X 200600501 NC Primary

Addresses

Primary practice location

105 Yadkin St
Suite 303
Albemarle, NC 28001-3449

Mailing address

PO Box 601888
Charlotte, NC 28260-1888
Phone (704) 982-2683

Other identifiers 3

IdentifierTypeStateIssuer
00539702MedicaidMS
1033156245MedicaidNC
5904693MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061206000323 NC Practitioner - Pediatric Medicine 8527036862 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006-00501NCMDPediatrics Physician
200600501NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Nov 1, 2009 Accepting new patients
Wake Forest University Health Sciences CurrentSince Nov 1, 2009 Accepting new patients
Blue Ridge Pediatric & Adolescent Medicine, Inc Pediatrics Past Accepting new patients

Locations

1930 N Peace Haven Rd
Winston Salem, NC 27106
Phone (336) 760-5400

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: lannymonroe@brpami.allscriptsdirect.net
  • Direct secure messaging: lmonroe@brpedsadolmed.trimed.direct-ci.com

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1033156245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601888",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601888",
            "telephone_number": "704-982-2683",
            "fax_number": "704-512-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 YADKIN ST",
            "address_2": "SUITE 303",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013449",
            "telephone_number": "704-982-2683",
            "fax_number": "704-512-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONROE",
        "first_name": "LANNY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2006-00501",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200600501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00539702",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033156245",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904693",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albemarle, NC

Sources for this page

Verify at the official NPI Registry.