Individual provider Active NPI

Kelsey Lane, PA-C

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1144037722
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.009173RX Issued in OH
Practice address
460 W 10TH Ave
Columbus, OH 43210-1240
Phone
(614) 293-7449
Fax
(614) 366-2360
NPI assigned
Dec 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.009173RX OH Primary

Addresses

Primary practice location

460 W 10TH Ave
Columbus, OH 43210-1240

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-7449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20250213002585 OH Practitioner - Physician Assistant 6103356514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Internal Medicine LLCGroup PAC ID 5496651408, 1,141 clinicians

Practice addresses (Care Compare)

3900 Stoneridge LN
Dublin, OH 43017-2288
Phone (614) 366-5001

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

450 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

452 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

460 W 10TH Ave
Columbus, OH 43210-1240
Phone (800) 293-5066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1144037722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-7449",
            "fax_number": "614-366-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-7449",
            "fax_number": "614-366-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "KELSEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-17",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.009173RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.