Active NPI
Mary Anne Lane, RN
- Registered Nurse
- Kenansville, NC
National Provider Identifier
1487767091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 063889
- Practice address
- 340 Seminary St.
Kenansville, NC 28349 - Phone
- (910) 296-2130
- Fax
- (910) 296-2139
- NPI assigned
- Aug 16, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 063889 | NC | Primary |
Addresses
Primary practice location
340 Seminary St.
Kenansville, NC 28349
Mailing address
350 Ludie Brown Rd
Chinquapin, NC 28521-8638
Phone (910) 285-4651
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 063889 | NC | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Duplin | Past | Accepting new patients | |
| County of Duplin | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- State or Local Public Health Clinic/Center
- Kenansville, NC
- NPI 1235198177
-
- Land Ambulance
- Kenansville, NC
- NPI 1508919069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487767091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 LUDIE BROWN RD",
"city": "CHINQUAPIN",
"state": "NC",
"postal_code": "285218638",
"telephone_number": "910-285-4651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 SEMINARY ST.",
"city": "KENANSVILLE",
"state": "NC",
"postal_code": "28349",
"telephone_number": "910-296-2130",
"fax_number": "910-296-2139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "MARY",
"middle_name": "ANNE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "063889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kenansville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.