NPIMap

Individual provider Active NPI

Kathleen A Lange, M.D.

  • Family Medicine Physician
  • Centerville, IA
National Provider Identifier
1811085848
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30574 Issued in IA
Practice address
707 S Main St
Centerville, IA 52544-2421
Phone
(641) 437-4344
Fax
(641) 856-5410
NPI assigned
Oct 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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
Family Medicine Physician 207Q00000X 30574 IA Primary

Addresses

Primary practice location

707 S Main St
Centerville, IA 52544-2421

Mailing address

707 S Main St
Centerville, IA 52544-2421
Phone (641) 437-4344

Other identifiers 1

IdentifierTypeStateIssuer
1110031MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081217000661 IA Practitioner - Family PracticePractitioner - General PracticePractitioner - Emergency Medicine 2163512393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

707 S Main St
Centerville, IA 52544-2421
Phone (641) 437-4344

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
17.93 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
59.77

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30574IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chariton Valley Medical Center PC Family Medicine CurrentSince Jan 2, 1997 Accepting new patients
Mercy Medical Center-Centerville Past Accepting new patients

Locations

707 S Main St
Centerville, IA 52544
Phone (641) 437-4344

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811085848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S MAIN ST",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525442421",
            "telephone_number": "641-437-4344",
            "fax_number": "641-856-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S MAIN ST",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525442421",
            "telephone_number": "641-437-4344",
            "fax_number": "641-856-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "30574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1110031",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, IA

Sources for this page

Verify at the official NPI Registry.