Keith J Lane, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

180506-1205 Issued in UT

Practice address

82 S 1100 E
204
Salt Lake City, UT 84102-1686

Phone

(801) 350-4602

Fax

(801) 350-4753

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  Medicare reassignment NPD
• University of Utah Hospitals and Clinics

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1982642252

  Internal Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1558370361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 S 1100 E",
            "address_2": "SUITE 204",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021686",
            "telephone_number": "801-350-4602",
            "fax_number": "801-350-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 S 1100 E",
            "address_2": "204",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021686",
            "telephone_number": "801-350-4602",
            "fax_number": "801-350-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "KEITH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "180506-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxanne Landsman, RD
• Richard Stayner Landward, LCSW
• Katherine Olga Lane Neal, MD
• Christen Lane
• Emily Lane
• Michael Conrad Lane, D.C.
• Michael Lindberg Lane, MD
• Roni Deann Lane I, M.D.
• Amber Lanenga, PHYSICAL THERAPIST
• Emiree Lang

• Internal Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.