Individual provider Active NPI

Cynthia K Lane, RN-C,PNP

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1063513711
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
224937 Issued in TX
Practice address
4131 S Buckner Blvd Ste a
Dallas, TX 75227-4318
Phone
(214) 388-0202
NPI assigned
Sep 26, 2006
Last updated
May 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 224937 TX Primary

Addresses

Primary practice location

4131 S Buckner Blvd Ste a
Dallas, TX 75227-4318

Mailing address

4131 S Buckner Blvd Ste a
Dallas, TX 75227-4318
Phone (214) 388-0202

Other identifiers 1

IdentifierTypeStateIssuer
338169101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
224937TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Healthcare for Children Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12984/brand/1/csg/1/fhir/r4

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, 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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1063513711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 S BUCKNER BLVD STE A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752274318",
            "telephone_number": "214-388-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 S BUCKNER BLVD STE A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752274318",
            "telephone_number": "214-388-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "CYNTHIA",
        "middle_name": "K",
        "credential": "RN-C,PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "224937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "338169101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.