Individual provider Active NPI

Christine Lane, APRN

  • Nurse Practitioner
  • Ellisville, MO
National Provider Identifier
1265754147
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2009034995 Issued in MO
Practice address
16105 Manchester Rd
Ellisville, MO 63011-2001
Phone
(866) 825-3227
NPI assigned
Feb 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2009034995 MO
Nurse Practitioner 363L00000X 2009034995 MO Primary

Addresses

Primary practice location

16105 Manchester Rd
Ellisville, MO 63011-2001

Mailing address

1296 Jeffco Blvd
Arnold, MO 63010-2138
Phone (636) 321-8618

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address clane102609@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Direct

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
I20100430000686 MO Practitioner - Nurse Practitioner 2769510361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians

Practice addresses (Care Compare)

12303 Depaul Dr
SSM Health Depaul Hospital Physician Billin
Bridgeton, MO 63044-2512
Phone (314) 344-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St Louis CurrentSince Oct 1, 2020 Accepting new patients
SSM Medical Group, Inc. Nurse Practitioner CurrentSince Jan 1, 2022 Accepting new patients
SSM Health Care St. Louis CurrentSince Oct 1, 2020 Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1296 Jeffco Blvd
Arnold, MO 63010
Phone (636) 321-8600

1345 Smizer Mill Rd
Ste 1350
Fenton, MO 63026

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1120 Shackelford Rd
Florissant, MO 63031
Phone (314) 830-5805

2022 Dorsett Vlg
Maryland Heights, MO 63043
Phone (314) 520-0520

1475 Kisker Rd
Ste 120
Saint Charles, MO 63304
Phone (636) 498-7400

711 Veterans Memorial Pkwy
Saint Charles, MO 63303
Phone (636) 669-2200

8820 Manchester Rd
Saint Louis, MO 63144
Phone (314) 963-8100

2341 S Brentwood Blvd
Saint Louis, MO 63144
Phone (314) 731-6265

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

Organizations & group practices 4

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 2

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": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1265754147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1296 JEFFCO BLVD",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630102138",
            "telephone_number": "636-321-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16105 MANCHESTER RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112001",
            "telephone_number": "866-825-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "CHRISTINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-19",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2009034995",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2009034995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clane102609@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "clane102609@direct-ehr-ssmhc.com",
            "address_1": "1296 Jeffco Blvd",
            "city": "Arnold",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630102138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1296 Jeffco Blvd",
            "city": "Arnold",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630102138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ellisville, MO

Sources for this page

Verify at the official NPI Registry.