Individual provider Active NPI

Lane Preston Fodel, CRNP

  • Acute Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1295026292
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R165067 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-9503
NPI assigned
Apr 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R165067 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

22 S Greene St
Baltimore, MD 21201-1544
Phone (410) 328-9503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20140930002400 MD Practitioner - Nurse Practitioner 6406016096 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland General Clinical Practice Group, Inc.Group PAC ID 8123926649, 61 clinicians

Practice addresses (Care Compare)

827 Linden Ave
Baltimore, MD 21201-4606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R165067MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. Acute Care CurrentSince Jan 9, 2023 Accepting new patients
Maryland General Clinical Practice Group, Inc. CurrentSince May 4, 2020 Accepting new patients
University of Maryland Physicians P.a. Current Accepting new patients
University of Maryland Physicians, P.a. CurrentSince Feb 11, 2024 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients
University of Maryland Midtown Health Inc CurrentSince Sep 28, 2016 Accepting new patients
Maryland General Clinical Practice Group, Inc. CurrentSince May 4, 2020 Accepting new patients
University of Maryland Emergency Medicine Associates, PA CurrentSince Aug 4, 2014 Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince Jan 9, 2023 Accepting new patients
University of Maryland Physicians P.a. CurrentSince Feb 11, 2024 Accepting new patients

Locations

105 Penn St
Baltimore, MD 21201
Phone (410) 328-2387

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

821 N Eutaw St
Baltimore, MD 21201
Phone (410) 225-9185

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

6535 N Charles St
Ste 125
Towson, MD 21204
Phone (443) 849-3779

Interoperability endpoints

  • Direct secure messaging: lfodel89041@direct.umm.edu

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1295026292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODEL",
        "first_name": "LANE",
        "middle_name": "PRESTON",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-25",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R165067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.