Individual provider Active NPI

Taylor Elaine Lane, PA-C

  • Physician Assistant
  • Pensacola, FL
National Provider Identifier
1477047181
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111541 Issued in FL
Practice address
4901 Marketplace Road
Pensacola, FL 32504-8986
Phone
(850) 484-4080
Fax
(850) 484-8113
NPI assigned
Jun 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111541 FL Primary

Addresses

Primary practice location

4901 Marketplace Road
Pensacola, FL 32504-8986

Mailing address

2455 Semoran Dr
Pensacola, FL 32503-8203
Phone (850) 982-6909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190226003436 FL Practitioner - Physician Assistant 7012256654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Pain Consultants LLCGroup PAC ID 1658516570, 37 clinicians

Practice addresses (Care Compare)

4901 Market Place Rd
Pensacola, FL 32504-8986
Phone (850) 484-4080

5102 N Davis Hwy
Pensacola, FL 32503-2030
Phone (850) 549-4960

Hospital & facility affiliations

  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093
  • Gulf Breeze Hospital Hospital, Gulf Breeze, FL, CCN 100266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9111541FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Pain Consultants LLC CurrentSince Dec 17, 2018 Accepting new patients
Gulf Coast Pain Consultants LLC CurrentSince Dec 17, 2018 Accepting new patients
Gulf Coast Pain Consultants LLC CurrentSince Dec 17, 2018 Accepting new patients

Locations

1600 Jenks Ave
Ste 2
Panama City, FL 32405

4901 Market Place Rd
Pensacola, FL 32504
Phone (850) 439-5425

5102 N Davis Hwy
Pensacola, FL 32503
Phone (850) 484-8800

1040 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-6555

Interoperability endpoints

  • Direct secure messaging: taylor.morrison.1@11679.direct.athenahealth.com

Organizations & group practices 3

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 3

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": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1477047181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 SEMORAN DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325038203",
            "telephone_number": "850-982-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 MARKETPLACE ROAD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048986",
            "telephone_number": "850-484-4080",
            "fax_number": "850-484-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "TAYLOR",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.