Individual provider Active NPI

Sandra B Lane, D.C.

  • Chiropractor
  • Tunkhannock, PA
National Provider Identifier
1720044480
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-004456-L Issued in PA
Practice address
166 W Tioga St
Tunkhannock, PA 18657-1466
Phone
(570) 836-2751
Fax
(570) 836-3290
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-004456-L PA Primary

Addresses

Primary practice location

166 W Tioga St
Tunkhannock, PA 18657-1466

Mailing address

PO Box 813
166 West Tioga Street
Tunkhannock, PA 18657-0813
Phone (570) 836-2751

Other identifiers 3

IdentifierTypeStateIssuer
0012324490002MedicaidPA
60656880OtherPASTATE INDUSTRIAL ACCIDENT
815631OtherPAPPO NUMBER B3

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120309000530 PA Practitioner - Chiropractic 3274516984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

166 W Tioga St
Tunkhannock, PA 18657-1466
Phone (570) 836-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-004456-LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lane Chiropractic and Medical Center Chiropractor CurrentSince Jul 1, 2002 Accepting new patients

Locations

166 W Tioga St
Tunkhannock, PA 18657
Phone (570) 836-2751

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1720044480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 813",
            "address_2": "166 WEST TIOGA STREET",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186570813",
            "telephone_number": "570-836-2751",
            "fax_number": "570-836-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 W TIOGA ST",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186571466",
            "telephone_number": "570-836-2751",
            "fax_number": "570-836-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "SANDRA",
        "middle_name": "B",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC-004456-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012324490002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE INDUSTRIAL ACCIDENT",
            "identifier": "60656880",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPO NUMBER B3",
            "identifier": "815631",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tunkhannock, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.