Active NPI
John L. Lanoue, M.D.
- Pediatric Surgery Physician
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- J4285
- Practice address
- 12200 Park Central Dr Ste 400
Dallas, TX 75251-2116 - Phone
- (214) 483-9300
- Fax
- (214) 483-9301
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | J4285 | TX | Primary |
Addresses
Primary practice location
12200 Park Central Dr Ste 400
Dallas, TX 75251-2116
Mailing address
12200 Park Central Dr Ste 400
Dallas, TX 75251-2116
Phone (214) 483-9300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1074006003 | Other | TX | CIGNA |
| 116113506 | Medicaid | TX | |
| 8J5630 | Other | TX | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Magella Medical Associates Billing, Inc. | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Pediatric Surgical Associates | Pediatric Surgery | Past | Accepting new patients |
Locations
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
1965 S Fremont Ave
Ste 300
Springfield, MO 65804
Phone (417) 820-2936
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165
1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429
12200 Park Central Dr
Ste 400
Dallas, TX 75251
Phone (972) 991-5437
815 Market St
Galveston, TX 77550
Phone (409) 770-6600
11777 FM 1960 Rd W
Houston, TX 77065
Phone (832) 828-3501
3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115
3001 George Bush Hwy
Ste 250
Richardson, TX 75082
Phone (888) 822-2855
111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000
421 E State Highway 114
Southlake, TX 76092
Phone (817) 865-4400
Organizations & group practices 5
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.
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- Family Medicine Physician
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-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
- Family Medicine Physician
- Hollister, MO
- NPI 1053350454
-
- Pediatric Surgery Physician
- Plano, TX
- NPI 1508995358
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589846400000",
"number": "1093809410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12200 PARK CENTRAL DR STE 400",
"city": "DALLAS",
"state": "TX",
"postal_code": "752512116",
"telephone_number": "214-483-9300",
"fax_number": "214-483-9301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12200 PARK CENTRAL DR STE 400",
"city": "DALLAS",
"state": "TX",
"postal_code": "752512116",
"telephone_number": "214-483-9300",
"fax_number": "214-483-9301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANOUE",
"first_name": "JOHN",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2020-05-19",
"certification_date": "2020-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "TX",
"license": "J4285",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1074006003",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "116113506",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "8J5630",
"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 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.