NPIMap

Individual provider Active NPI

Lori M Moran, PA-C

  • Physician Assistant
  • Coal Township, PA
National Provider Identifier
1811325780
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056532 Issued in PA
Practice address
4203 Hospital Rd
Coal Township, PA 17866-9668
Phone
(570) 648-4010
Fax
(570) 648-5076
NPI assigned
Oct 31, 2013
Last updated
Dec 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA056532 PA Primary

Addresses

Primary practice location

4203 Hospital Rd
Coal Township, PA 17866-9668

Mailing address

4203 Hospital Rd
Coal Township, PA 17866-9668
Phone (570) 648-4010

Other names 1

  • Lori M Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20140114000754 PA Practitioner - Physician Assistant 2163650409 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

1611 Pond Rd
Allentown, PA 18104-2258

325 W Broad St
LVPG Internal Medicine
Bethlehem, PA 18018-5526
Phone (484) 626-9200

325 W Broad St 2ND FL
Bethlehem, PA 18018-5526

3701 Corriere Rd
Easton, PA 18045-7991

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA056532PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Dec 2, 2013 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 3, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 3, 2017 Accepting new patients
Geisinger Clinic CurrentSince Dec 2, 2013 Accepting new patients

Locations

1665 Valley Center Pkwy
Ste 130
Bethlehem, PA 18017
Phone (610) 317-0208

4203 Hospital Rd
Coal Township, PA 17866
Phone (570) 486-4588

100 N Academy Ave
Danville, PA 17822

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Organizations & group practices 6

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 11

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

NPI Registry JSON

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

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1811325780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 HOSPITAL RD",
            "city": "COAL TOWNSHIP",
            "state": "PA",
            "postal_code": "178669668",
            "telephone_number": "570-648-4010",
            "fax_number": "570-648-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 HOSPITAL RD",
            "city": "COAL TOWNSHIP",
            "state": "PA",
            "postal_code": "178669668",
            "telephone_number": "570-648-4010",
            "fax_number": "570-648-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "LORI",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-31",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "JOHNSON",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coal Township, PA

Sources for this page

Verify at the official NPI Registry.