Individual provider Active NPI

Malynda Christine Lane, FNP-BC

  • Adult Health Nurse Practitioner
  • Troy, MO
National Provider Identifier
1255707907
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2016023910 Issued in MO
Practice address
1000 E Cherry St
Troy, MO 63379-1513
Phone
(636) 528-3486
Fax
(636) 528-3419
NPI assigned
Aug 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2016023910 MO Primary
Family Nurse Practitioner 363LF0000X 95001746 CA
Family Nurse Practitioner 363LF0000X 2016023910 MO

Addresses

Primary practice location

1000 E Cherry St
Troy, MO 63379-1513

Mailing address

1000 E Cherry St
Troy, MO 63379-1513
Phone (636) 352-9215

Other practice location 1

One Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-4908

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190522000354 MO Practitioner - Nurse Practitioner 8921373598 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians

Practice addresses (Care Compare)

1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-4141

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 237-4200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95001746CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Lincoln CurrentSince Jun 27, 2020 Accepting new patients
The Curators of the University of Missouri CurrentSince Apr 15, 2024 Accepting new patients
Mercy Hospital Lincoln CurrentSince Jun 27, 2020 Accepting new patients
Curators of the University of Missouri CurrentSince Apr 15, 2024 Accepting new patients
Mercy East Ambulatory Services LLC CurrentSince Sep 1, 2024 Accepting new patients
Mercy Hospitals East Communities CurrentSince May 6, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince May 6, 2019 Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

11445 Olive Blvd
Saint Louis, MO 63141
Phone (314) 428-9543

625 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-0175

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1255707907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791513",
            "telephone_number": "636-352-9215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791513",
            "telephone_number": "636-528-3486",
            "fax_number": "636-528-3419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652120001",
            "country_code": "US",
            "telephone_number": "573-882-4908",
            "fax_number": "573-884-5184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "MALYNDA",
        "middle_name": "CHRISTINE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2024-04-16",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2016023910",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001746",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016023910",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "One Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.