Individual provider Active NPI

Janice Lynn Lazear, CRNP

  • Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1699921981
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
21585 Issued in TN
Practice address
202 W Fairview Ave
Johnson City, TN 37604-5611
Phone
(423) 439-4225
Fax
(423) 439-7371
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R117674 MD
Nurse Practitioner 363L00000X 21585 TN Primary

Addresses

Primary practice location

202 W Fairview Ave
Johnson City, TN 37604-5611

Mailing address

365 Stout Drive
Box 70403
Johnson City, TN 37614
Phone (423) 439-4515

Other identifiers 1

IdentifierTypeStateIssuer
Q024045MedicaidTN

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
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
21585TNMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1699921981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 STOUT DRIVE",
            "address_2": "BOX 70403",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37614",
            "telephone_number": "423-439-4515",
            "fax_number": "423-439-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W FAIRVIEW AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045611",
            "telephone_number": "423-439-4225",
            "fax_number": "423-439-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZEAR",
        "first_name": "JANICE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R117674",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "21585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q024045",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.