Lane Dermatologic Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LANE DERMATOLOGIC SURGERY CENTER, LLC

Practice address

1210 Brookstone Centre Pkwy
Columbus, GA 31904-2954

Phone

(706) 322-1717

Fax

(706) 322-1718

NPI assigned

Jun 2, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Joshua Edward Lane, M.D.NPI 1336146091

Title

Provider/President

Phone

(706) 322-1717

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Lane Dermatologic Surgery Center LLCCCN 11C0001424

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joshua Edward Lane, M.D.

  • MOHS-Micrographic Surgery Physician
  • Columbus, GA
  • NPI 1336146091
  NPD Authorized official
• Tanda Nichole Lane, M.D.

  • Procedural Dermatology Physician
  • Columbus, GA
  • NPI 1891824108
  NPD

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1922392364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 BROOKSTONE CENTRE PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319042954",
            "telephone_number": "706-322-1717",
            "fax_number": "706-322-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 BROOKSTONE CENTRE PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319042954",
            "telephone_number": "706-322-1717",
            "fax_number": "706-322-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANE DERMATOLOGIC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-02",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PROVIDER/PRESIDENT",
        "authorized_official_telephone_number": "706-322-1717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Lee Land
• Oliver Allyn Landin
• Landings of Columbus LLC
• Landmark Counseling Services, LLC
• Bobby G Landrum, NP
• Lane Dermatology & Dermatologic Surgery LLC
• Joshua Edward Lane, M.D.
• Tanda Nichole Lane, M.D.
• Tanisha Zakia Lane
• William Blake Lane, D.D.S., M.S.D., PC

• Ambulatory Surgical Clinic/Center in Columbus, GA
• Providers in Columbus, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.