Lana J Cooper, P.A.

Individual provider Active NPI Physician Assistant · Louisburg, NC

NPI 1154624617 · NPPES record last updated Nov 15, 2019

Key facts

NPI
1154624617
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
0010-02602 (NC)
Practice address
107 Industrial Dr Ste C
Louisburg, NC 27549-2371
Phone
(919) 496-2533
Fax
(919) 496-8140
NPI assigned
Dec 6, 2010
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20130110000332 NC Practitioner - Physician Assistant 2365695988 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Louisburg Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lana.cooper@direct.fchd.nchie.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-02602 NC Yes

Addresses

Primary practice location

107 Industrial Dr Ste C
Louisburg, NC 27549-2371

Mailing address

107 Industrial Dr Ste C
Louisburg, NC 27549-2371
Phone (919) 496-2533

Other names

  • Lana J Allen Former name

Other providers in Louisburg, NC

All providers in Louisburg, NC · Physician Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.