Individual provider Active NPI

Lanita Reid, P.A.C.

  • Medical Physician Assistant
  • Huntsville, AL
National Provider Identifier
1508935271
Registry record updated Sep 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003841 Issued in GA
Practice address
2325 Pansy St SW Ste E
Huntsville, AL 35801-3827
Phone
(256) 533-4626
Fax
(256) 533-4710
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003841 GA Primary

Addresses

Primary practice location

2325 Pansy St SW Ste E
Huntsville, AL 35801-3827

Mailing address

2325 Pansy St SW Ste E
Huntsville, AL 35801-3827
Phone (256) 533-4626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20090922000355 AL Practitioner - Physician Assistant 4385790070 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Consultants LLCGroup PAC ID 5092603472, 17 clinicians

Practice addresses (Care Compare)

2780 Bob Wallace Ave
Hunstville, AL 35805-4104
Phone (256) 533-4626

2780 Bob Wallace Ave SW
Huntsville, AL 35805-4104

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003841GAMDMedical Physician Assistant

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.

Hospital & facility affiliations 1

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251763200000",
    "number": "1508935271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 PANSY ST SW STE E",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013827",
            "telephone_number": "256-533-4626",
            "fax_number": "256-533-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 PANSY ST SW STE E",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013827",
            "telephone_number": "256-533-4626",
            "fax_number": "256-533-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "LANITA",
        "name_prefix": "Ms.",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.