Individual provider Active NPI

Karen Elizabeth Lane, ARNP-BC

  • Family Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1336370360
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN145860 Issued in GA
Practice address
730 Glynn St S
Fayetteville, GA 30214-2050
Phone
(770) 460-3650
NPI assigned
Aug 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2084672 FL
Family Nurse Practitioner 363LF0000X RN145860 GA Primary

Addresses

Primary practice location

730 Glynn St S
Fayetteville, GA 30214-2050

Mailing address

PO Box 850001
Orlando, FL 32885-0394
Phone (904) 282-6331

Other practice location 1

8225 Normandy Blvd
Jacksonville, FL 32221-6650
Phone (904) 378-8520

Other identifiers 1

IdentifierTypeStateIssuer
001441400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100105000261 FL Practitioner - Nurse Practitioner 1153462767 Reassigns benefits to 1 organization
I20210809000697 GA Practitioner - Nurse Practitioner 1153462767 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

3200 Shakerag HL
Peachtree City, GA 30269-6524
Phone (770) 487-0760

4000 Shakerag HL
Peachtree City, GA 30269-4047

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2084672FLMDFamily Nurse Practitioner
RN145860GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Physicians Services, LLC Family CurrentSince Jul 1, 2021 Accepting new patients
Piedmont Medical Care Corporation CurrentSince May 2, 2022 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Aug 9, 2024 Accepting new patients
Miami Jewish Health Systems, Inc. CurrentSince Jul 17, 2017 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Aug 9, 2024 Accepting new patients

Locations

5200 NE 2nd Ave
Miami, FL 33137
Phone (305) 762-1387

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

3535 Ashton Woods Dr NE
Brookhaven, GA 30319
Phone (770) 451-0236

730 Glynn St S
Fayetteville, GA 30214
Phone (770) 460-3650

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: karen.lane.1@8042.direct.athenahealth.com

Organizations & group practices 5

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": "1249689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1336370360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328850394",
            "telephone_number": "904-282-6331",
            "fax_number": "904-282-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 GLYNN ST S",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142050",
            "telephone_number": "770-460-3650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8225 Normandy Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322216650",
            "country_code": "US",
            "telephone_number": "904-378-8520",
            "fax_number": "904-378-8570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "KAREN",
        "middle_name": "ELIZABETH",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-08",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "2084672",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN145860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001441400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.