Individual provider Active NPI

Cornelia Lane, AG-ACNP

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1982009049
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11040095 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Oct 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11040095 FL Primary
Acute Care Nurse Practitioner 363LA2100X 5007296 NC

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

201 E Grover St
Shelby, NC 28150-3917
Phone (980) 487-3678

Other practice location 1

201 E Grover St
Shelby, NC 28150-3917
Phone (980) 487-3678

Other identifiers 2

IdentifierTypeStateIssuer
1982009049MedicaidNC
QNP283MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150109002203 NC Practitioner - Nurse Practitioner 9032433578 Reassigns benefits to 4 organizations
I20250626003410 FL Practitioner - Nurse Practitioner 9032433578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

250 Hospital Dr
Lexington, NC 27292-6792
Phone (336) 716-2734

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5007296NCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince May 16, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jun 23, 2025 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 16, 2024 Accepting new patients
Hospice of Iredell County, Inc CurrentSince Oct 3, 2017 Accepting new patients
Carolinas Medical Center CurrentSince May 16, 2024 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 16, 2024 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jun 23, 2025 Accepting new patients
Wake Forest University Health Sciences CurrentSince Nov 17, 2014 Accepting new patients
Columbus Regional Health Network Past Accepting new patients
Columbus Regional Health Network Past Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

201 E Grover St
Shelby, NC 28150
Phone (704) 487-3000

2347 Simonton Rd
Statesville, NC 28625
Phone (704) 873-4719

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: clane2753461@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

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.

Hospital & facility affiliations 5

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": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1982009049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E GROVER ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503917",
            "telephone_number": "980-487-3678",
            "fax_number": "980-487-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Grover St",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "NC",
            "postal_code": "281503917",
            "country_code": "US",
            "telephone_number": "980-487-3678",
            "fax_number": "980-487-3294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "CORNELIA",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11040095",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5007296",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982009049",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "QNP283",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.