Active NPI
Mary E Lane, CNP
- Women's Health Nurse Practitioner
- Bozeman, MT
National Provider Identifier
1578532032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- RN18707
- Practice address
- 300 N Willson
Suite 2001
Bozeman, MT 59715-3572 - Phone
- (406) 587-0681
- Fax
- (406) 587-9011
- NPI assigned
- Mar 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | RN18707 | MT | Primary |
Addresses
Primary practice location
300 N Willson
Suite 2001
Bozeman, MT 59715-3572
Mailing address
300 N Willson
Suite 2001
Bozeman, MT 59715-3572
Phone (406) 587-0681
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P74886 | Other | MT | MEDICARE UPIN |
| 0434538 | Medicaid | MT |
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
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN18707 | MT | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgercare | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Non-Surgical Family Planning Clinic/Center
- Bozeman, MT
- NPI 1700855830
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1578532032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 N WILLSON",
"address_2": "SUITE 2001",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597153572",
"telephone_number": "406-587-0681",
"fax_number": "406-587-9011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 N WILLSON",
"address_2": "SUITE 2001",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597153572",
"telephone_number": "406-587-0681",
"fax_number": "406-587-9011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "MARY",
"middle_name": "E",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-16",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MT",
"license": "RN18707",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE UPIN",
"identifier": "P74886",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0434538",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.