Active NPI
Sara Lane
- Registered Nurse
- Galivants Ferry, SC
National Provider Identifier
1407446073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 253204
- Practice address
- 144 Penn Cir
Galivants Ferry, SC 29544-8678 - Phone
- (843) 433-2331
- NPI assigned
- Jan 19, 2021
- Last updated
- Jan 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 253204 | SC | Primary |
Addresses
Primary practice location
144 Penn Cir
Galivants Ferry, SC 29544-8678
Mailing address
144 Penn Cir
Galivants Ferry, SC 29544-8678
Phone (843) 433-2331
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0346490902 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 253204 | SC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1407446073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 PENN CIR",
"city": "GALIVANTS FERRY",
"state": "SC",
"postal_code": "295448678",
"telephone_number": "843-433-2331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "144 PENN CIR",
"city": "GALIVANTS FERRY",
"state": "SC",
"postal_code": "295448678",
"telephone_number": "843-433-2331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "SARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-19",
"last_updated": "2021-01-19",
"certification_date": "2021-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "253204",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0346490902",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Galivants Ferry, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.