Individual provider Active NPI

Lanlen Luke Venable, PA-C

  • Medical Physician Assistant
  • Raleigh, NC
National Provider Identifier
1306300520
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
4414 Lake Boone TRL Ste 502
Raleigh, NC 27607-7521
Phone
(919) 875-0539
Fax
(919) 875-1051
NPI assigned
Jan 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

4414 Lake Boone TRL Ste 502
Raleigh, NC 27607-7521

Mailing address

4414 Lake Boone TRL Ste 502
Raleigh, NC 27607-7521
Phone (919) 875-0539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190314001952 NC Practitioner - Physician Assistant 1254671027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mississippi Medical College, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Family Practice, P.a.Group PAC ID 0840292637, 6 clinicians

Practice addresses (Care Compare)

4414 Lake Boone TRL
Suite 502
Raleigh, NC 27607-7521
Phone (919) 875-0539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Family Practice, P.a. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lanlen.venable.1@30034.direct.athenahealth.com

Organizations & group practices 2

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": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1306300520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 502",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077521",
            "telephone_number": "919-875-0539",
            "fax_number": "919-875-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 502",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077521",
            "telephone_number": "919-875-0539",
            "fax_number": "919-875-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENABLE",
        "first_name": "LANLEN",
        "middle_name": "LUKE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.