NPIMap

Individual provider Active NPI

Ryan Rex Lagrange, MD

  • Internal Medicine Physician
  • Greenville, NC
National Provider Identifier
1487114526
Registry record updated Dec 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2022-01334 Issued in NC
Practice address
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone
(252) 847-4100
NPI assigned
Mar 24, 2019
Last updated
Dec 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 2022-01334 NC Primary

Addresses

Primary practice location

2100 Stantonsburg Rd
Greenville, NC 27834-2818

Mailing address

PO Box 8427
Greenville, NC 27835-8427
Phone (252) 847-1562

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rlagrange380359@direct.vidanthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220719002263 NC Practitioner - Internal Medicine 8628310208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Brody School of Medicine at East Carolina University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-1757

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Jul 18, 2022 Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

Interoperability endpoints

  • Direct secure messaging: rlagrange380359@direct.ecuhealth.com
  • Direct secure messaging: rlagrange380359@direct.vidanthealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670716800000",
    "number": "1487114526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8427",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278358427",
            "telephone_number": "252-847-1562",
            "fax_number": "800-209-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-847-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGRANGE",
        "first_name": "RYAN",
        "middle_name": "REX",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-24",
        "last_updated": "2022-12-11",
        "certification_date": "2022-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2022-01334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlagrange380359@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.