Jacob Lane

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

P23269 Issued in NC

Practice address

1019 Broad St
Durham, NC 27705-4143

Phone

(919) 797-9588

NPI assigned

Jun 11, 2024

Sex

Male

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 NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Florida College of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bull City Physical TherapyGroup PAC ID 8022438563, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Bull City Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • Durham, NC
  • NPI 1235749060
  Medicare reassignment Care Compare group NPD
• Acupuncture and Chiropractic Care Center Inc.

  • Chiropractor
  • Durham, NC
  • NPI 1740760248
  NPD

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1447092358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5914 WOODLAWN DRIVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054143",
            "telephone_number": "919-797-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "P23269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lane to Change Counseling PLLC
• Felicia Lane-Carter
• Caley Jane Burrus Lane, MD, PHD
• Douglas Timothy Lane, PA-C
• Ilana Beth Lane, PH.D.
• Kathryn Lane
• Kristian Lane, LCMHC, NCC
• Kristine Spicer Lane, MD
• Madeleine R Lane, PSYD
• Shelby Nicole Lane, LCSW-A

• Physical Medicine & Rehabilitation Physician in Durham, NC
• Providers in Durham, NC by specialty
• Physical Medicine & Rehabilitation Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.