Individual provider Active NPI

Lee J Lane, ARNP

  • Pediatric Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1730118811
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP30005017 Issued in WA
Practice address
105 W 8TH Ave
Ste 418
Spokane, WA 99204-2302
Phone
(509) 747-3081
Fax
(509) 455-8462
NPI assigned
Jul 1, 2006
Last updated
Dec 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP30005017 WA Primary

Addresses

Primary practice location

105 W 8TH Ave
Ste 418
Spokane, WA 99204-2302

Mailing address

105 W 8TH Ave
Ste 418
Spokane, WA 99204-2302
Phone (509) 747-3081

Other identifiers 1

IdentifierTypeStateIssuer
9624941MedicaidWA

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP30005017WAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1730118811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W 8TH AVE",
            "address_2": "STE 418",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042302",
            "telephone_number": "509-747-3081",
            "fax_number": "509-455-8462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 8TH AVE",
            "address_2": "STE 418",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042302",
            "telephone_number": "509-747-3081",
            "fax_number": "509-455-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "LEE",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP30005017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9624941",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.