Brett Jack Lancaster, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4412 Issued in ID

Practice address

1361 E 16TH St
#2
Burley, ID 83318-2008

Phone

(208) 677-5198

Fax

(208) 678-2245

NPI assigned

May 31, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: brett.lancaster.p1@direct.fhsid.nextgenshare.com

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.

• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Buhl, ID
  • NPI 1003862525
  NPD (past)
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1124571815
  NPD (past)
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1235279217
  NPD (past)
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Shoshone, ID
  • NPI 1841932498

  General Practice

  NPD (past)

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

{
    "created_epoch": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355097600000",
    "number": "1619296605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 EASTLAND DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016856",
            "telephone_number": "208-734-3312",
            "fax_number": "208-734-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 E 16TH ST",
            "address_2": "#2",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182008",
            "telephone_number": "208-677-5198",
            "fax_number": "208-678-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "BRETT",
        "middle_name": "JACK",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-31",
        "last_updated": "2012-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan L Koepnick, LPC
• Karrie Rae Kondel, ARNP
• Seth Koyle
• Mary Kraemer
• Evan Kress, PT
• Michael Andrew Larsen, D.D.S.
• Melissa Jo Larson, LPC
• LB Medical Consultants
• Leeana Hauser
• Nicholas Lewis, PT, DPT

• General Practice Dentistry in Burley, ID
• Providers in Burley, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; 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.