Active NPI
Kelly Lane, PA-C
- Physician Assistant
- Nashua, NH
National Provider Identifier
1952765745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1164
- Practice address
- 29 Northwest Blvd
Nashua, NH 03063-4068 - Phone
- (603) 577-2273
- Fax
- (603) 579-5191
- NPI assigned
- Apr 8, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1164 | NH | Primary |
Addresses
Primary practice location
29 Northwest Blvd
Nashua, NH 03063-4068
Mailing address
PO Box 3677
Nashua, NH 03061-3677
Phone (603) 577-7900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1164 | NH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460073600000",
"number": "1952765745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3677",
"city": "NASHUA",
"state": "NH",
"postal_code": "030613677",
"telephone_number": "603-577-7900",
"fax_number": "603-577-7972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 NORTHWEST BLVD",
"city": "NASHUA",
"state": "NH",
"postal_code": "030634068",
"telephone_number": "603-577-2273",
"fax_number": "603-579-5191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "KELLY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-08",
"last_updated": "2016-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NH",
"license": "1164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nashua, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.