Individual provider Active NPI

Fred Hagen Laningham III, MD

  • Pediatric Radiology Physician
  • Palo Alto, CA
National Provider Identifier
1962405753
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
G75723 Issued in CA
Practice address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone
(650) 497-8000
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 29598 TN
Diagnostic Radiology Physician 2085R0202X 29598 TN
Diagnostic Radiology Physician 2085R0202X G75723 CA
Pediatric Radiology Physician 2085P0229X G75723 CA Primary

Addresses

Primary practice location

725 Welch Rd
Palo Alto, CA 94304-1601

Mailing address

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000

Other practice location 1

262 Danny Thomas Pl
Memphis, TN 38105-3678
Phone (901) 595-3300

Other identifiers 18

IdentifierTypeStateIssuer
00G75723MedicaidCA
1110990MedicaidLA
200354520AMedicaidIN
7613057MedicaidNC
100249677-00MedicaidNE
200347310AMedicaidKS
0030911MedicaidNJ
104677750MedicaidMI
143636001MedicaidAR
64044696MedicaidKY
0089692MedicaidMT
009975820MedicaidAL
218597956AMedicaidGA
422400000MedicaidME
00124209MedicaidMS
205329717MedicaidMO
3863255MedicaidTN
0547182MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040623000727 TN Practitioner - Diagnostic Radiology 4082699095 Reassigns benefits to 1 organization
I20161109001531 CA Practitioner - Diagnostic Radiology 4082699095 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Arkansas College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wishon Radiological Medical Group IncGroup PAC ID 8022065036, 13 clinicians

Practice addresses (Care Compare)

9300 Valley Childrens PL
Madera, CA 93636-8761
Phone (559) 353-5917

Hospital & facility affiliations

  • Valley Children'S Hospital Hospital, Madera, CA, CCN 053300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G75723CAMDDiagnostic Radiology Physician
29598TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Jun 8, 2022 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Jul 3, 2018 Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Jun 8, 2022 Accepting new patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Mar 14, 2018 Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Mar 14, 2018 Accepting new patients
Stanford Health Care Diagnostic Radiology Current Accepting new patients
Wishon Radiological Medical Group, Inc. Pediatric Radiology CurrentSince Sep 27, 2016 Accepting new patients
St Jude Children'S Research Hospital, Inc. CurrentSince Jan 1, 2021 Accepting new patients
Stanford Health Care Diagnostic Radiology CurrentSince Jun 8, 2022 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Jul 3, 2018 Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
St Jude Childrens Research Hospital Inc Past Accepting new patients
Valley Children'S Hospital Past Accepting new patients

Locations

2300 Clayton Rd
Ste 160
Concord, CA 94520
Phone (925) 825-7777

6121 Hollis St
Ste 1
Emeryville, CA 94608
Phone (510) 601-7979

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

2201 Walnut Ave
Ste 150
Fremont, CA 94538
Phone (510) 713-1234

7202 N Millbrook Ave
Fresno, CA 93720
Phone (559) 450-2662

7202 N Millbrook Ave
Ste 206
Fresno, CA 93720
Phone (559) 450-2300

6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

114 La Casa Via
Ste 100
Walnut Creek, CA 94598
Phone (925) 937-6100

262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343

262 Danny Thomas Pl
#515
Memphis, TN 38105
Phone (901) 495-3006

Interoperability endpoints

  • Direct secure messaging: flaningham21449@stjude.direct-ci.com

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

Hospital & facility affiliations 2

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1962405753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "262 Danny Thomas Pl",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381053678",
            "country_code": "US",
            "telephone_number": "901-595-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANINGHAM",
        "first_name": "FRED",
        "middle_name": "HAGEN",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TN",
            "license": "29598",
            "primary": false
        },
        {
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            "taxonomy_group": "",
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            "license": "29598",
            "primary": false
        },
        {
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            "taxonomy_group": "",
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            "state": "CA",
            "license": "G75723",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
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            "license": "G75723",
            "primary": true
        }
    ],
    "identifiers": [
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        {
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    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.