Bradley Mart Lane, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001654 Issued in VA

Practice address

700 Wenonah Ave
Pearisburg, VA 24134-1638

Phone

(540) 921-4116

NPI assigned

Jul 6, 2007

Last updated

May 25, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA, WV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2007

Medicare assignment

May accept Medicare assignment

Group practices

New River Eye Care Family Optometry PCGroup PAC ID 7618152950, 5 clinicians

Appalachian Eye Care IncGroup PAC ID 1951588730, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blane@appalachianeyecare.eyefinity-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New River Eye Care Family Optometry PC

  • Optometrist
  • Pearisburg, VA
  • NPI 1750672622
  Medicare reassignment Care Compare group NPD Authorized official
• Appalachian Eye Care Inc

  • Optometrist
  • Princeton, WV
  • NPI 1548551336
  Medicare reassignment Care Compare group NPD
• New River Eye Care

  • Optometrist
  • Pearisburg, VA
  • NPI 1134319593
  NPD (past)
• Vistar Eye Center, Inc

  • Eyewear Supplier
  • Roanoke, VA
  • NPI 1265128037

  Optometrist

  NPD (past)
• Appalachian Eye Care

  • Optometrist
  • Princeton, WV
  • NPI 1578756631
  NPD (past)

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1255539607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 RIDGEWAY DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247409775",
            "telephone_number": "304-546-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WENONAH AVE",
            "city": "PEARISBURG",
            "state": "VA",
            "postal_code": "241341638",
            "telephone_number": "540-921-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "BRADLEY",
        "middle_name": "MART",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810010275",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Danielle Holt
• Blake Hopkins, OD
• Hunt Enterprises Inc (Greenbrier Contract Services)
• Hannah Danielle Keating
• Kimberlee R Ketchersid, PA
• Laura Goodrich Anesthesia Services Inc
• Angela Renae Lilly, FNP-BC
• Ravi Kiran Lingineni, DDS
• Lupo's Medical Transportation Company
• Jonathan M Marshall, CRNA

• Optometrist in Pearisburg, VA
• Providers in Pearisburg, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.