Individual provider Active NPI

Jessica D Lane, APN

  • Pediatric Nurse Practitioner
  • Elizabethton, TN
National Provider Identifier
1801373964
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN24503 Issued in TN
Practice address
1500 W Elk Ave
Elizabethton, TN 37643-2654
Phone
(423) 543-2584
Fax
(423) 722-2060
NPI assigned
Jul 23, 2018
Last updated
Jul 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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 APN24503 TN Primary

Addresses

Primary practice location

1500 W Elk Ave
Elizabethton, TN 37643-2654

Mailing address

401 E Main St
Johnson City, TN 37601-4877
Phone (423) 431-0509

Other practice location 1

401 E Main St
Johnson City, TN 37601-4877
Phone (423) 929-2584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181015000006 TN Practitioner - Nurse Practitioner 1052663473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.39 of 100Reported as group
Quality
86.98
Promoting interoperability
92
Improvement activities
40
Cost
80.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care PLLC CurrentSince Aug 5, 2018 Accepting new patients

Locations

132 Old Gray Station Rd
Johnson City, TN 37615
Phone (423) 467-8001

401 E Main St
Johnson City, TN 37601
Phone (423) 722-2062

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, 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": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1801373964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E MAIN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014877",
            "telephone_number": "423-431-0509",
            "fax_number": "423-722-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W ELK AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432654",
            "telephone_number": "423-543-2584",
            "fax_number": "423-722-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 E Main St",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376014877",
            "country_code": "US",
            "telephone_number": "423-929-2584",
            "fax_number": "423-722-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "JESSICA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "APN24503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethton, TN

Sources for this page

Verify at the official NPI Registry.