Active NPI
Ebonie Lane, NP
- Nurse Practitioner
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5008075
- Practice address
- 1001 Blythe Blvd
Ste 300- Adult Cardiology
Charlotte, NC 28203-5866 - Phone
- (704) 373-0212
- NPI assigned
- Oct 12, 2015
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5008075 | NC | Primary |
Addresses
Primary practice location
1001 Blythe Blvd
Ste 300- Adult Cardiology
Charlotte, NC 28203-5866
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
10650 Park Rd
Suite 220
Charlotte, NC 28210-8538
Phone (704) 667-3840
Other practice location 2
1001 Blythe Blvd
Ste 300 - Cardiac Surgery
Charlotte, NC 28203-5866
Phone (704) 373-0212
Other practice location 3
200 Medical Park Dr
Ste 230
Concord, NC 28025-2982
Phone (704) 403-1349
Other practice location 4
1001 Blythe Blvd
STE 300 - Thoracic Surgery
Charlotte, NC 28203-5866
Phone (704) 373-0212
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5008075 | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbus Regional Health Network | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Whiteville, NC
- NPI 1518263268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581897600000",
"number": "1972974384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19305",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282199305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 BLYTHE BLVD",
"address_2": "STE 300- ADULT CARDIOLOGY",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035866",
"telephone_number": "704-373-0212"
}
],
"practiceLocations": [
{
"address_1": "10650 Park Rd",
"address_2": "Suite 220",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282108538",
"country_code": "US",
"telephone_number": "704-667-3840",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1001 Blythe Blvd",
"address_2": "Ste 300 - Cardiac Surgery",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282035866",
"country_code": "US",
"telephone_number": "704-373-0212",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 Medical Park Dr",
"address_2": "Ste 230",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "NC",
"postal_code": "280252982",
"country_code": "US",
"telephone_number": "704-403-1349",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1001 Blythe Blvd",
"address_2": "STE 300 - Thoracic Surgery",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282035866",
"country_code": "US",
"telephone_number": "704-373-0212",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LANE",
"first_name": "EBONIE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-12",
"last_updated": "2020-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5008075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.