Active NPI
Dalvin Rojhotte Lane, M.D.
- Internal Medicine Physician
- Decatur, GA
National Provider Identifier
1962620401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 055613
- Practice address
- 2496 Columbia Dr
Decatur, GA 30034-1769 - Phone
- (404) 534-9222
- NPI assigned
- Apr 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 055613 | GA | Primary |
| Internal Medicine Physician | 207R00000X | ME93723 | FL |
Addresses
Primary practice location
2496 Columbia Dr
Decatur, GA 30034-1769
Mailing address
PO Box 769609
Roswell, GA 30076-8224
Phone (866) 474-1934
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160713000498 | GA | Order and Referring Only - Internal Medicine | 9133273790 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME93723 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392076800000",
"number": "1962620401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 769609",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300768224",
"telephone_number": "866-474-1934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2496 COLUMBIA DR",
"city": "DECATUR",
"state": "GA",
"postal_code": "300341769",
"telephone_number": "404-534-9222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "DALVIN",
"middle_name": "ROJHOTTE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-22",
"last_updated": "2014-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "055613",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME93723",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.