Active NPI
Michael Jeffery Lane, ATP
- Other Technician
- Baton Rouge, LA
National Provider Identifier
1194078360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- ATP 2652
- Practice address
- 10632 Alco Ave
Unit 1
Baton Rouge, LA 70816-4238 - Phone
- (866) 795-4825
- Fax
- (877) 723-6236
- NPI assigned
- Oct 24, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | ATP 2652 | IL | Primary |
Addresses
Primary practice location
10632 Alco Ave
Unit 1
Baton Rouge, LA 70816-4238
Mailing address
1622 Bellrose Dr
Baton Rouge, LA 70815-5433
Phone (504) 210-9293
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ATP 2652 | IL | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1194078360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1622 BELLROSE DR",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708155433",
"telephone_number": "504-210-9293",
"fax_number": "877-723-6236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10632 ALCO AVE",
"address_2": "UNIT 1",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708164238",
"telephone_number": "866-795-4825",
"fax_number": "877-723-6236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "MICHAEL",
"middle_name": "JEFFERY",
"credential": "ATP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-24",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "IL",
"license": "ATP 2652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.