Jordan Lane

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA00963 Issued in MS

Practice address

5850 E Still Cir
Mesa, AZ 85206-3618

Phone

(630) 962-9440

NPI assigned

Jun 4, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Horn Lake Family Practice IncGroup PAC ID 9537198213, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Horn Lake Family Practice Inc

  • Adolescent Medicine (Family Medicine) Physician
  • Horn Lake, MS
  • NPI 1508968421
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1447091475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063618",
            "telephone_number": "630-962-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063618",
            "telephone_number": "630-962-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MS",
            "license": "PA00963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Landrum, PA-C
• Shannon Dawn Landry, PTA
• Bonnie Landspurg, RN
• Brittany Lane
• John P Lane, D.C., F.I.A.M.A
• Sharin Lane, DPT
• Brittany Nicole Lang, BA, BHT
• Jacob Phillip Lang, PHARMD
• Loriann Rochelle Lang, CPNP
• Morgan Lang

• Medical Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.