Individual provider Active NPI

Grant A Lane, MD

  • Anesthesiology Physician
  • Savannah, GA
National Provider Identifier
1619236866
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
75579 Issued in GA
Practice address
11705 Mercy Blvd
Savannah, GA 31419-1711
Phone
(912) 819-4100
NPI assigned
May 9, 2012
Last updated
Dec 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 75579 GA Primary

Addresses

Primary practice location

11705 Mercy Blvd
Savannah, GA 31419-1711

Mailing address

PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839

Other practice location 1

210 E DeRenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

Other practice location 2

5353 Reynolds St
Savannah, GA 31405-6015
Phone (912) 355-7214

Other practice location 3

247 S Main St
Reidsville, GA 30453-4605
Phone (912) 557-1207

Other practice location 4

215 Mims Rd
Sylvania, GA 30467-1994
Phone (912) 827-6536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20160802001810 GA Practitioner - Anesthesiology 6507017936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Oklahoma College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Anesthesiology Associates of Georgia LLCGroup PAC ID 7618934779, 230 clinicians

Practice addresses (Care Compare)

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 819-4100

215 Mims Rd
Sylvania, GA 30467-1994
Phone (912) 827-6536

247 S Main St
Reidsville, GA 30453-4605
Phone (912) 557-1207

2701 N Decatur Rd
Decatur, GA 30033-5918
Phone (678) 514-1991

5353 Reynolds St
Savannah, GA 31405-6015
Phone (912) 819-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
75579GAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology Associates of Georgia, LLC Anesthesiology CurrentSince Jul 1, 2016 Accepting new patients

Locations

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

247 S Main St
Reidsville, GA 30453
Phone (912) 557-1207

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

215 Mims Rd
Sylvania, GA 30467
Phone (912) 557-1207

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1619236866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "855-851-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11705 MERCY BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191711",
            "telephone_number": "912-819-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 E DeRenne Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056736",
            "country_code": "US",
            "telephone_number": "912-644-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5353 Reynolds St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056015",
            "country_code": "US",
            "telephone_number": "912-355-7214",
            "fax_number": "912-354-2479",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "247 S Main St",
            "address_purpose": "LOCATION",
            "city": "Reidsville",
            "state": "GA",
            "postal_code": "304534605",
            "country_code": "US",
            "telephone_number": "912-557-1207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 Mims Rd",
            "address_purpose": "LOCATION",
            "city": "Sylvania",
            "state": "GA",
            "postal_code": "304671994",
            "country_code": "US",
            "telephone_number": "912-827-6536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "GRANT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "75579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.