Organization Active NPI

Lane Chiropractic and Medical Center

  • Chiropractor
  • Tunkhannock, PA
National Provider Identifier
1104097716
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC004456L Issued in PA
Legal business name
LANE CHIROPRACTIC AND MEDICAL CENTER
Practice address
166 W Tioga St
Tunkhannock, PA 18657-1466
Phone
(570) 836-2751
Fax
(570) 836-3290
NPI assigned
Mar 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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

Authorized official

Name
Dr. Sandra B Lane, DCNPI 1720044480
Title
Owner/Member
Phone
(570) 836-2751

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC004456L PA Primary

Addresses

Primary practice location

166 W Tioga St
Tunkhannock, PA 18657-1466

Mailing address

PO Box 813
Tunkhannock, PA 18657-0813
Phone (570) 836-2751

Other identifiers 1

IdentifierTypeStateIssuer
07789366MedicaidPA

Other names 1

  • Lane Chiropractic and Wellness Center Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040611000963 PA Part B Supplier - Clinic/Group Practice 6204819915 Receives reassigned benefits from 4 practitioners
Practice locations: Tunkhannock, PA

National Provider Directory

National Provider Directory

Locations

166 W Tioga St
Tunkhannock, PA 18657
Phone (570) 836-2751

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356566400000",
    "number": "1104097716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 813",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186570813",
            "telephone_number": "570-836-2751",
            "fax_number": "570-836-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 W TIOGA ST",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186571466",
            "telephone_number": "570-836-2751",
            "fax_number": "570-836-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANE CHIROPRACTIC AND MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-23",
        "last_updated": "2012-12-27",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "570-836-2751",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC004456L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07789366",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lane Chiropractic and Wellness Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tunkhannock, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.