Kristopher Olen Lane, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20909 Issued in SC

Practice address

122 Latimer St
Latta, SC 29565-1828

Phone

(843) 627-6252

NPI assigned

Apr 3, 2017

Last updated

Apr 27, 2023By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Caresouth Carolina Inc.Group PAC ID 1052221314, 66 clinicians

Lowcountry Urgent Care LLCGroup PAC ID 9739210337, 81 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health-Pee Dee Home health agency, Florence, SC, CCN 427854
• McLeod Medical Center - Dillon Hospital, Dillon, SC, CCN 420005

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristopher.lane@csci.eclinicaldirectplus.com

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.

• Caresouth Carolina, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hartsville, SC
  • NPI 1720082571
  Medicare reassignment Care Compare group NPD
• Lowcountry Urgent Care LLC

  dba Lowcountry Urgent Care

  • Primary Care Nurse Practitioner
  • Beaufort, SC
  • NPI 1326364100
  Medicare reassignment Care Compare group NPD
• Caresouth Carolina, Inc

  • Federally Qualified Health Center (FQHC)
  • Society Hill, SC
  • NPI 1194763714
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Capital Care Resources of South Carolina, LLC

  dba CenterWell Home Health

  • Home Health Agency
  • Florence, SC
  • NPI 1528433521
  Care Compare affiliation
• McLeod Medical Center-Dillon

  • General Acute Care Hospital
  • Dillon, SC
  • NPI 1598746141
  Care Compare affiliation

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1306378856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295511090",
            "telephone_number": "843-857-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 LATIMER ST",
            "city": "LATTA",
            "state": "SC",
            "postal_code": "295651828",
            "telephone_number": "843-627-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "KRISTOPHER",
        "middle_name": "OLEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4553",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SCA484",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heavenly Hands Nursing Services
• Hope Health Agency LLC
• Teri Arlana Jackson
• Souleika Johnson
• Sandra Jones, LPES
• Latta Drug Company, Inc.
• Latta Drug Company, Inc.
• Latta Rescue Squad, Inc.
• Latta Smiles
• Sharonda Rawls Legette, FNP-C

• Family Nurse Practitioner in Latta, SC
• Providers in Latta, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.