Individual provider Active NPI

Patrick Franklin Lane, O.D.

  • Optometrist
  • Middlesboro, KY
National Provider Identifier
1649309808
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
KY1601 Issued in KY
Practice address
1507 US Highway 25 E
Middlesboro, KY 40965-1862
Phone
(606) 248-3474
Fax
(606) 248-3937
NPI assigned
Mar 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X KY1601 KY Primary

Addresses

Primary practice location

1507 US Highway 25 E
Middlesboro, KY 40965-1862

Mailing address

1507 US Highway 25 E
Middlesboro, KY 40965-1862
Phone (606) 248-3474

Other identifiers 1

IdentifierTypeStateIssuer
77005502MedicaidKY

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

State licenses

LicenseStateTypeSpecialty
KY1601KYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Miller Eye Care PC Optometrist Past Accepting new patients
Miller Eye Care Optometrist Past Accepting new patients

Organizations & group practices 2

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649309808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 US HIGHWAY 25 E",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651862",
            "telephone_number": "606-248-3474",
            "fax_number": "606-248-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 US HIGHWAY 25 E",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651862",
            "telephone_number": "606-248-3474",
            "fax_number": "606-248-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "PATRICK",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "KY1601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77005502",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlesboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.