Active NPI
Mary Penfield Lane, CRNP
- Family Nurse Practitioner
- Birmingham, AL
National Provider Identifier
1871634683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1-025087
- Practice address
- 5369 Pineywood Rd
Birmingham, AL 35242-3424 - Phone
- (205) 991-6426
- NPI assigned
- Feb 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-025087 | AL | Primary |
Addresses
Primary practice location
5369 Pineywood Rd
Birmingham, AL 35242-3424
Mailing address
5369 Pineywood Rd
Birmingham, AL 35242-3424
Phone (205) 991-6426
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51529456 | Other | AL | BCBS OF AL |
| 51556190 | Other | AL | BCBS OF AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-025087 | AL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1871634683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5369 PINEYWOOD RD",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352423424",
"telephone_number": "205-991-6426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5369 PINEYWOOD RD",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352423424",
"telephone_number": "205-991-6426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "MARY",
"middle_name": "PENFIELD",
"name_prefix": "Mrs.",
"credential": "CRNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "1-025087",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF AL",
"identifier": "51529456",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF AL",
"identifier": "51556190",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.