Individual provider Active NPI

David R Lance, DO

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Wooster, OH
National Provider Identifier
1043491061
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
34003501L Issued in OH
Practice address
1900 Akron Rd
Wooster, OH 44691-2518
Phone
(330) 264-4899
Fax
(330) 264-4874
NPI assigned
Nov 19, 2007
Last updated
Sep 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 34003501L OH Primary

Addresses

Primary practice location

1900 Akron Rd
Wooster, OH 44691-2518

Mailing address

1900 Akron Rd
Wooster, OH 44691-2518
Phone (330) 264-4899

Other identifiers 1

IdentifierTypeStateIssuer
0519111MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621000893 OH Practitioner - Family Practice 7012992415 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34003501LOHMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifecare Hospice Hospice and Palliative Medicine CurrentSince Jan 1, 2004 Accepting new patients
Pure Healthcare LLC Hospice and Palliative Medicine CurrentSince Dec 1, 2021 Accepting new patients
Lifecare Hospice Hospice and Palliative Medicine CurrentSince Jan 1, 2004 Accepting new patients

Locations

2200 Miami Valley Dr
Dayton, OH 45459
Phone (937) 668-7873

7575 Paragon Rd
Dayton, OH 45459
Phone (937) 256-4490

832 S Main St
Orrville, OH 44667
Phone (330) 456-2695

1761 Beall Ave
Wooster, OH 44691
Phone (330) 263-8100

1900 Akron Rd
Wooster, OH 44691
Phone (330) 264-4899

2525 Back Orrville Rd
Wooster, OH 44691
Phone (330) 264-4899

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": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1043491061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 AKRON RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912518",
            "telephone_number": "330-264-4899",
            "fax_number": "330-264-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 AKRON RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912518",
            "telephone_number": "330-264-4899",
            "fax_number": "330-264-4874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCE",
        "first_name": "DAVID",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-19",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "34003501L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0519111",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.