Individual provider Active NPI

Michelle Ann Lane, FNP-C

  • Family Nurse Practitioner
  • Salem, OR
National Provider Identifier
1134403082
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201150144NP Issued in OR
Practice address
1655 State St
Salem, OR 97301-4232
Phone
(503) 581-1198
Fax
(503) 339-9565
NPI assigned
Oct 10, 2011
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201150144NP OR Primary

Addresses

Primary practice location

1655 State St
Salem, OR 97301-4232

Mailing address

1655 State St
Salem, OR 97301-4232
Phone (503) 581-1198

Other identifiers 1

IdentifierTypeStateIssuer
500640317MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlanefnp@direct.practicefusion.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20120119000861 OR Practitioner - Nurse Practitioner 2668411802 Reassigns benefits to 1 organization
Practice locations: Salem, OR

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1655 State St
Salem, OR 97301-4232
Phone (503) 581-1198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Two Lanes LLC Family CurrentSince Jan 7, 2020 Accepting new patients

Locations

1655 State St
Salem, OR 97301
Phone (503) 581-1198

3000 Market St NE
Ste 530
Salem, OR 97301
Phone (503) 581-1198

3760 Market St NE
Salem, OR 97301
Phone (503) 540-8837

Interoperability endpoints

  • Direct secure messaging: mlanefnp@direct.practicefusion.com

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": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1134403082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014232",
            "telephone_number": "503-581-1198",
            "fax_number": "503-339-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014232",
            "telephone_number": "503-581-1198",
            "fax_number": "503-339-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201150144NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500640317",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlanefnp@direct.practicefusion.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1655 State St",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973014232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.