Individual provider Active NPI

Lance McCary

  • Physician Assistant
  • Greenville, KY
National Provider Identifier
1407308497
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
440 Hopkinsville St
Greenville, KY 42345-1124
Phone
(270) 338-8000
NPI assigned
Oct 26, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

440 Hopkinsville St
Greenville, KY 42345-1124

Mailing address

6335 S East St
Indianapolis, IN 46227-7112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 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
I20200323000806 AZ Practitioner - Physician Assistant 4880977420 Reassigns benefits to 1 organization
I20211119001215 TX Practitioner - Physician Assistant 4880977420 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Aug 2, 2021 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Aug 2, 2021 Accepting new patients

Locations

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

Organizations & group practices 3

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": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1407308497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6335 S EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462277112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 HOPKINSVILLE ST",
            "city": "GREENVILLE",
            "state": "KY",
            "postal_code": "423451124",
            "telephone_number": "270-338-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARY",
        "first_name": "LANCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, KY

Sources for this page

Verify at the official NPI Registry.