NPIMap

Organization Active NPI

Lane Women's Health Group PC

  • Obstetrics & Gynecology Physician
  • Jamestown, NY
National Provider Identifier
1265760235
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
131973 Issued in NY
Legal business name
LANE WOMEN'S HEALTH GROUP PC
Practice address
400 Foote Ave
Jamestown, NY 14701
Phone
(716) 484-9194
Fax
(716) 484-0115
NPI assigned
Dec 2, 2009
Last updated
Sep 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Mrs. Collette K Keith
Title
Practice Manager
Phone
(716) 484-9194

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 131973 NY Primary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 199070 NY
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X F334150 NY
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X MW417569 NY
Women's Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SW0102X
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X

Addresses

Primary practice location

400 Foote Ave
Jamestown, NY 14701

Mailing address

400 Foote Ave
Jamestown, NY 14701-6800
Phone (716) 484-9194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100308000583 NY Part B Supplier - Clinic/Group Practice 0143365668 Receives reassigned benefits from 9 practitioners
Practice locations: Jamestown, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0173890Lane Women's Health Group PC400 Foote Avenue, Jamestown, NY 14701Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1265760235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016800",
            "telephone_number": "716-484-9194",
            "fax_number": "716-484-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FOOTE AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "14701",
            "telephone_number": "716-484-9194",
            "fax_number": "716-484-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANE WOMEN'S HEALTH GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-02",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "COLLETTE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "716-484-9194",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "131973",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "199070",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334150",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "MW417569",
            "primary": false
        },
        {
            "code": "364SW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.