Individual provider Active NPI

Lane Natividad, CPNP

  • Pediatric Nurse Practitioner
  • Goldsboro, NC
National Provider Identifier
1598049843
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5005330 Issued in NC
Practice address
2706 Medical Office PL
Goldsboro, NC 27534-9460
Phone
(919) 734-4736
Fax
(919) 580-1017
NPI assigned
Oct 5, 2011
Last updated
Mar 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5005330 NC Primary

Addresses

Primary practice location

2706 Medical Office PL
Goldsboro, NC 27534-9460

Mailing address

2706 Medical Office PL
Goldsboro, NC 27534-9460
Phone (919) 734-4736

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lnatividad@goldsboropediatrics.opdirect.net Direct

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
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5005330NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goldsboro Pediatrics PA Past Accepting new patients
Goldsboro Pediatrics PA Past Accepting new patients
Goldsboro Pediatrics PA PastSince Dec 24, 2023 Accepting new patients
Goldsboro Pediatrics PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lnatividad@goldsboropeds.medentdirect.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1598049843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349460",
            "telephone_number": "919-734-4736",
            "fax_number": "919-580-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349460",
            "telephone_number": "919-734-4736",
            "fax_number": "919-580-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATIVIDAD",
        "first_name": "LANE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5005330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lnatividad@goldsboropediatrics.opdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2706 Medical Office Pl",
            "city": "Goldsboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275349460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.