Active NPI
Carole C Lane, M.D.
- Internal Medicine Physician
- Brewton, AL
National Provider Identifier
1477501633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 00011195
- Practice address
- 1108 Douglas Ave
Brewton, AL 36426-1579 - Phone
- (251) 867-1711
- Fax
- (251) 867-1474
- NPI assigned
- May 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 00011195 | AL | Primary |
| Dermatology Physician | 207N00000X | 11195 | AL |
Addresses
Primary practice location
1108 Douglas Ave
Brewton, AL 36426-1579
Mailing address
1108 Douglas Ave
Brewton, AL 36426-1579
Phone (251) 867-1711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LA000082064 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00011195 | AL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372204800000",
"number": "1477501633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 DOUGLAS AVE",
"city": "BREWTON",
"state": "AL",
"postal_code": "364261579",
"telephone_number": "251-867-1711",
"fax_number": "251-867-1474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 DOUGLAS AVE",
"city": "BREWTON",
"state": "AL",
"postal_code": "364261579",
"telephone_number": "251-867-1711",
"fax_number": "251-867-1474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "CAROLE",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-04",
"last_updated": "2013-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AL",
"license": "00011195",
"primary": true
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "AL",
"license": "11195",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LA000082064",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brewton, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.