Individual provider Active NPI

Stuart Kent Lankford, PA-C

  • Medical Physician Assistant
  • Carbondale, IL
National Provider Identifier
1053833343
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085006142 Issued in IL
Practice address
1350 Cedar CT
Carbondale, IL 62901-5336
Phone
(618) 529-2955
Fax
(618) 457-7823
NPI assigned
Jul 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 085.006142 IL
Medical Physician Assistant 363AM0700X 085006142 IL Primary

Addresses

Primary practice location

1350 Cedar CT
Carbondale, IL 62901-5336

Mailing address

1350 Cedar CT
Carbondale, IL 62901-5336
Phone (618) 529-2955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20171108000248 IL Practitioner - Physician Assistant 7012273022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Disease and Medicine Specialty Consultants LLCGroup PAC ID 1052391521, 6 clinicians

Practice addresses (Care Compare)

20 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Phone (618) 529-2955

Hospital & facility affiliations

  • Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
  • Herrin Hospital Hospital, Herrin, IL, CCN 140011
  • St Joseph Memorial Hospital Hospital, Murphysboro, IL, CCN 141334

Merit-based Incentive Payment System (MIPS)

Final score
81.56 of 100Reported as individual
Quality
53.64
Improvement activities
40
Cost
67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.006142ILMDNephrology Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1499558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053833343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015336",
            "telephone_number": "618-529-2955",
            "fax_number": "618-457-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015336",
            "telephone_number": "618-529-2955",
            "fax_number": "618-457-7823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANKFORD",
        "first_name": "STUART",
        "middle_name": "KENT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "085.006142",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085006142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.