NPIMap

Individual provider Active NPI

Charles S Lane III, MD

  • Psychiatry Physician
  • Hot Springs, AR
National Provider Identifier
1427051663
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C5421 Issued in AR
Practice address
300 Werner St
Hot Springs, AR 71913-6406
Phone
(501) 802-0013
Fax
(501) 623-1465
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C5421 AR Primary

Addresses

Primary practice location

300 Werner St
Hot Springs, AR 71913-6406

Mailing address

PO Box 6005
Hot Springs, AR 71902-6005
Phone (501) 802-0013

Other identifiers 4

IdentifierTypeStateIssuer
260001316OtherARRAILROAD MEDICARE
B002OtherARWPS TRICARE
102459001MedicaidAR
53036OtherARBLUE CROSS BLUE SHIELD AR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040712000461 AR Practitioner - Psychiatry 8224016753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Arkansas College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Clinic IncGroup PAC ID 6204885304, 20 clinicians

Practice addresses (Care Compare)

310 Whittington Ave
Hot Springs, AR 71901-3406
Phone (501) 623-3477

Hospital & facility affiliations

  • CHI St. Vincent Hospital Hot Springs Hospital, Hot Springs, AR, CCN 040026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C5421ARMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Clinic, Inc. CurrentSince Feb 20, 2012 Accepting new patients
Counseling Clinic, Inc Psychiatry CurrentSince Feb 20, 2012 Accepting new patients
Counseling Clinic, Inc Past Accepting new patients
Dayspring Services of Arkansas L.L.C. Past Accepting new patients
Counseling Clinic, Inc PastSince Sep 17, 2023 Accepting new patients

Locations

110 Pearson
Benton, AR 72015
Phone (501) 315-4224

310 Whittington Ave
Hot Springs National Park, AR 71901
Phone (501) 623-3477

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1427051663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6005",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719026005",
            "telephone_number": "501-802-0013",
            "fax_number": "501-623-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WERNER ST",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136406",
            "telephone_number": "501-802-0013",
            "fax_number": "501-623-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "CHARLES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "C5421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "260001316",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE",
            "identifier": "B002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102459001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AR",
            "identifier": "53036",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

Verify at the official NPI Registry.