Jill M Lane LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100095 Issued in ID

Legal business name

JILL M LANE LLC

Practice address

405 E Main St
Grangeville, ID 83530-2239

Phone

(208) 983-3732

Fax

(208) 983-3738

NPI assigned

Apr 1, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jill Marie Lane, O.D.NPI 1427119254

Title

President/Physician

Phone

(208) 983-3732

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: dr.jillmlane@camasprairie.eyefinity-direct.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jill Marie Lane, O.D.

  • Optometrist
  • Grangeville, ID
  • NPI 1427119254
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1902078785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 E MAIN ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835302239",
            "telephone_number": "208-983-3732",
            "fax_number": "208-983-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E MAIN ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835302239",
            "telephone_number": "208-983-3732",
            "fax_number": "208-983-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL M LANE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "208-983-3732",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Dept of Health & Welfare Reg 2 CMH
• Idaho Dept of Health & Welfare Reg II Amh Grangeville
• Idaho Dept of Health & Welfare Reg II CMH Grangeville
• William Mark Imus Jr., FNP
• Irwin Drug Inc.
• Chad Guy Jungert, RPH
• Tricia Klement
• Christina L. Koehler, L.M.P.
• Jill Marie Lane, O.D.
• Melissa Lane, DPT

• Optometrist in Grangeville, ID
• Providers in Grangeville, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.