Individual provider Active NPI

Mary Elizabeth Lane, WHNP-BC, MSN

  • Obstetrics & Gynecology Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1295130839
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
19119 Issued in SC
Practice address
1350A Cleveland St
Greenville, SC 29607-2408
Phone
(864) 455-1600
NPI assigned
Oct 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 19119 SC Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 0024173336 VA

Addresses

Primary practice location

1350A Cleveland St
Greenville, SC 29607-2408

Mailing address

1181 First Colonial Rd
Ste 200
Virginia Beach, VA 23454-2437
Phone (757) 425-1600

Other practice location 1

1181 First Colonial Rd
Ste 200
Virginia Beach, VA 23454-2437
Phone (757) 425-1600

Other names 1

  • Mary Elizabeth Yarbro Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
19119SCMDObstetrics & Gynecology Nurse Practitioner
0024173336VAMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1295130839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1181 FIRST COLONIAL RD",
            "address_2": "STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542437",
            "telephone_number": "757-425-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350A CLEVELAND ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072408",
            "telephone_number": "864-455-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1181 First Colonial Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234542437",
            "country_code": "US",
            "telephone_number": "757-425-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "WHNP-BC, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "SC",
            "license": "19119",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "VA",
            "license": "0024173336",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "YARBRO",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.