Lisa Gabriel Lane, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

515 Issued in MA

Practice address

300 Market Street, Ste 112
Chapel Hill, NC 27516

Phone

(919) 969-9611

Fax

(919) 969-9615

NPI assigned

Apr 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Avance Care, PA

  • Clinic/Center
  • Fuquay Varina, NC
  • NPI 1487845020
  NPD (past)
• Village Pediatrics of Chapel Hill, PA

  • Pediatrics Physician
  • Chapel Hill, NC
  • NPI 1578650735
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1295792992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MARKET STREET, STE 112",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "27516",
            "telephone_number": "919-969-9611",
            "fax_number": "919-969-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MARKET STREET, STE 112",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "27516",
            "telephone_number": "919-969-9611",
            "fax_number": "919-969-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "LISA",
        "middle_name": "GABRIEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH",
            "identifier": "57183",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "AP0278",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE CHAMPUS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "4142200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY START",
            "identifier": "44944",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "8300399",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDRENS MED SECURITY",
            "identifier": "44944",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Landman, PSY.D.
• Landrum S. Tucker, Jr., Mdpa
• Bridget Landry, Q
• Colleen Elizabeth Landy, MGC
• Katherine Carlisle Lane, MD
• Nicole Louise Lane, PA-C
• Rafel Lane, MSW, LCSW
• Stacy Joelle Lane
• Bradley Carl Lang, LDN
• Kathryn Marie Lang, D.P.T.

• Physician Assistant in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.