Individual provider Active NPI

Lance Littell

  • Registered Nurse
  • Washington, PA
National Provider Identifier
1407629801
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
72475 Issued in WV
Practice address
114 Woodland Ave
Washington, PA 15301-2029
Phone
(304) 374-1937
NPI assigned
Nov 7, 2023
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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 117843 WV
Registered Nurse 163W00000X 72475 WV Primary

Addresses

Primary practice location

114 Woodland Ave
Washington, PA 15301-2029

Mailing address

114 Woodland Ave
Washington, PA 15301-2029
Phone (304) 374-1937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240628002438 OH Practitioner - Nurse Practitioner 1850835083 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72475WVMDRegistered Nurse
117843WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast, Inc CurrentSince May 4, 2024 Accepting new patients
Southeast, Inc CurrentSince May 4, 2024 Accepting new patients

Locations

16 W Long St
Columbus, OH 43215

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1407629801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WOODLAND AVE",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153012029",
            "telephone_number": "304-374-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND AVE",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153012029",
            "telephone_number": "304-374-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTELL",
        "first_name": "LANCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "117843",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "72475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, PA

Sources for this page

Verify at the official NPI Registry.