Lancet Rheumatology and Sara Lupus Clinic, PLLC

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

200000903 Issued in NC

Legal business name

LANCET RHEUMATOLOGY AND SARA LUPUS CLINIC, PLLC

Practice address

275 Executive Park Blvd Ste 601
Winston Salem, NC 27103

Phone

(336) 955-1838

Fax

(336) 955-1842

NPI assigned

May 25, 2016

Organization subpart

No

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

Authorized official

Name

Nilamadhab Mishra, MDNPI 1104801232

Title

Organizer and Member

Phone

(336) 918-3421

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nilamadhab Mishra, MD

  • Rheumatology Physician
  • Winston Salem, NC
  • NPI 1104801232
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1194173633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 EXECUTIVE PARK BLVD STE 601",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031548",
            "telephone_number": "336-955-1838",
            "fax_number": "336-955-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 EXECUTIVE PARK BLVD STE 601",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-955-1838",
            "fax_number": "336-955-1842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCET RHEUMATOLOGY AND SARA LUPUS CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-25",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "MISHRA",
        "authorized_official_first_name": "NILAMADHAB",
        "authorized_official_title_or_position": "ORGANIZER AND MEMBER",
        "authorized_official_telephone_number": "336-918-3421",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NC",
            "license": "200000903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89129CV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "129CV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "A9429",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John William Lancaster, DC
• Sarah Lancaster
• Brianna Hodges Lance, NP
• Thea Alexandra Lance, MD
• Lancet Rheumatology and Sara Lupus Clinic
• Darryl Landis, MD
• Leigha Doxtad Landreth, NP
• Adam Douglas Landsee, MD
• Haley Leilani Landwehr, M.D.
• Lane & Associates Xviii, DDS. PA

• Rheumatology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Rheumatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.