NPIMap

Individual provider Active NPI

Kevin B Lane, DO

  • Family Medicine Physician
  • Vernon, TX
National Provider Identifier
1619979044
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L8579 Issued in TX
Practice address
4103 Wilbarger St
Vernon, TX 76384-3137
Phone
(940) 553-2140
Fax
(940) 553-1739
NPI assigned
Aug 15, 2005
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L8579 TX Primary

Addresses

Primary practice location

4103 Wilbarger St
Vernon, TX 76384-3137

Mailing address

4103 Wilbarger St
Vernon, TX 76384-3137
Phone (940) 553-2140

Other identifiers 1

IdentifierTypeStateIssuer
165574802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040722001146 TX Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 7113907882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1982
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4103 Wilbarger St
Vernon, TX 76384-3137
Phone (940) 553-2140

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2313OKMDOptometrist
L8579TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hardeman County Memorial Hosp CurrentSince May 14, 2004 Accepting new patients
4301 Hospital Dr. Operations LLC Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Baylor County Hospital District Past Accepting new patients
Childress County Hospital District Past Accepting new patients
Newcastle Family Medicine Center Family Medicine Past Accepting new patients

Locations

402 Mercer St
Quanah, TX 79252
Phone (940) 663-2795

Organizations & group practices 7

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 7

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1619979044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 WILBARGER ST",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763843137",
            "telephone_number": "940-553-2140",
            "fax_number": "940-553-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 WILBARGER ST",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763843137",
            "telephone_number": "940-553-2140",
            "fax_number": "940-553-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "KEVIN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L8579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165574802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, TX

Sources for this page

Verify at the official NPI Registry.