Active NPI
Lanie M Koncilja, FNP
- Internal Medicine Physician
- Akron, OH
National Provider Identifier
1235638065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- APRN.CNP.023865
- Practice address
- 55 Arch St Ste 1B
Akron, OH 44304-1436 - Phone
- (330) 375-3315
- NPI assigned
- Feb 7, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | APRN.CNP.023865 | OH | Primary |
Addresses
Primary practice location
55 Arch St Ste 1B
Akron, OH 44304-1436
Mailing address
55 Arch St Ste 1B
Akron, OH 44304-1436
Phone (330) 375-3315
Other practice location 1
1 Shrader St Ste 578
San Francisco, CA 94117-1034
Phone (415) 876-5762
Other practice location 2
1 Akron General Ave
Akron, OH 44307
Phone (330) 344-6565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94-3069757 | Other | CA | PPO |
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)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.023865 | OH | MD | Internal Medicine Physician |
Interoperability endpoints
- lkoncilja26259@summahealth-direct.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576800000000",
"number": "1235638065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 ARCH ST STE 1B",
"city": "AKRON",
"state": "OH",
"postal_code": "443041436",
"telephone_number": "330-375-3315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 ARCH ST STE 1B",
"city": "AKRON",
"state": "OH",
"postal_code": "443041436",
"telephone_number": "330-375-3315"
}
],
"practiceLocations": [
{
"address_1": "1 Shrader St Ste 578",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941171034",
"country_code": "US",
"telephone_number": "415-876-5762",
"fax_number": "415-876-4538",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Akron General Ave",
"address_purpose": "LOCATION",
"city": "Akron",
"state": "OH",
"postal_code": "44307",
"country_code": "US",
"telephone_number": "330-344-6565",
"fax_number": "330-344-5799",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KONCILJA",
"first_name": "LANIE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-07",
"last_updated": "2019-12-20",
"certification_date": "2019-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "APRN.CNP.023865",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPO",
"identifier": "94-3069757",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.