NPIMap

Individual provider Active NPI

Derrick F Lane, M.D.

  • Family Medicine Physician
  • Macon, GA
National Provider Identifier
1124079447
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
052594 Issued in GA
Practice address
818 Forsyth Street
Macon, GA 31201-2139
Phone
(478) 633-7010
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 052594 GA Primary

Addresses

Primary practice location

818 Forsyth Street
Macon, GA 31201-2139

Mailing address

P.O. Box 28170
Macon, GA 31221-8170
Phone (478) 254-5943

Other identifiers 3

IdentifierTypeStateIssuer
155203137BMedicaidGA
155203137CMedicaidGA
P00Q81500OtherGARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050503000132 GA Practitioner - Family Practice 3577502186 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Meharry Medical College School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jasper Health Services Inc.Group PAC ID 7214901230, 8 clinicians

Practice addresses (Care Compare)

1118 Morningside Dr
Suite a
Perry, GA 31069-4950
Phone (478) 218-1420

898 A College St
Monticello, GA 31064-1258

898 College St
Monticello, GA 31064-1258
Phone (706) 468-0988

Hospital & facility affiliations

  • Amedisys Home Health of Macon Home health agency, Macon, GA, CCN 117093
  • Abbey Hospice Hospice, Social Circle, GA, CCN 111530
  • Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069
  • Jasper Memorial Hospital Hospital, Monticello, GA, CCN 111303
  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107
  • Retreat, the Nursing home, Monticello, GA, CCN 115675

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue420
Removal of skin lesions21
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
052594GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Derrick Lane, MD, LLC Family Medicine CurrentSince Dec 1, 2005 Accepting new patients
Houston Hospitals Inc CurrentSince Dec 6, 2012 Accepting new patients
Houston Hospitals Inc Current Accepting new patients
Jasper Health Services Inc. CurrentSince Jul 1, 2013 Accepting new patients
Precision Wound Care PC Family Medicine CurrentSince Feb 11, 2026 Accepting new patients
Jasper Health Services, Inc. Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
Jasper Health Services Inc. Past Accepting new patients
Vernu 2 Inc Past Accepting new patients

Locations

11680 Great Oaks Way
Ste 170
Alpharetta, GA 30022
Phone (404) 296-1130

818 Forsyth St
Macon, GA 31201
Phone (478) 633-7010

898 College St
Monticello, GA 31064
Phone (706) 468-0988

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

1118 Morningside Dr
Ste A
Perry, GA 31069
Phone (478) 218-1420

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

Interoperability endpoints

  • Direct secure messaging: derrick.lane@oconeeregional.gadirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/GBABED/Endpoint/GBABED

Organizations & group practices 8

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 7

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1124079447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 28170",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312218170",
            "telephone_number": "478-254-5943",
            "fax_number": "478-254-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 FORSYTH STREET",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012139",
            "telephone_number": "478-633-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "DERRICK",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "052594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155203137B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155203137C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00Q81500",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.