Individual provider Active NPI

Lane Clements Austell, PA-C

  • Physician Assistant
  • Rogers, AR
National Provider Identifier
1285344986
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1163 Issued in AR
Practice address
1000 S 52ND St
Rogers, AR 72758-8610
Phone
(479) 271-9607
Fax
(479) 271-2133
NPI assigned
Dec 5, 2022
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5312 TN
Physician Assistant 363A00000X PA-1163 AR Primary

Addresses

Primary practice location

1000 S 52ND St
Rogers, AR 72758-8610

Mailing address

1000 S 52ND St
Rogers, AR 72758-8610
Phone (901) 517-1434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20230428002825 AR Practitioner - Physician Assistant 7810352663 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, shared by 5 NPIs, 314 clinicians

Practice addresses (Care Compare)

2710 S Rife Medical LN
Rogers, AR 72758-1452

3101 SE 14TH St
Bentonville, AR 72712-4900
Phone (479) 631-2100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.41 of 100Reported as apm
Quality
79.26
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.15 of 100Reported as apm
Quality
88.15
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5312TNMDClinical Social Worker
PA-1163ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities CurrentSince Sep 1, 2024 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Sep 1, 2024 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Sep 1, 2024 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

1000 S 52nd St
Rogers, AR 72758
Phone (479) 271-9607

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1285344986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S 52ND ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588610",
            "telephone_number": "901-517-1434",
            "fax_number": "479-271-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S 52ND ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588610",
            "telephone_number": "479-271-9607",
            "fax_number": "479-271-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTELL",
        "first_name": "LANE",
        "middle_name": "CLEMENTS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-05",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5312",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-1163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.