Active NPI
Cornelia Lane, AG-ACNP
- Nurse Practitioner
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN11040095
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982009049 | Medicaid | NC | |
| QNP283 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5007296 | NC | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Medical Center | Current | Accepting new patients | |
| The Charlotte-Mecklenburg Hospital Authority | Current | Accepting new patients | |
| Mayo Clinic Jacksonville | Current | Accepting new patients | |
| The Charlotte-Mecklenburg Hospital Authority | Current | Accepting new patients | |
| Hospice of Iredell County, Inc | Current | Accepting new patients | |
| Carolinas Medical Center | Current | Accepting new patients | |
| The Charlotte-Mecklenburg Hospital Authority | Current | Accepting new patients | |
| Carolinas Medical Center | Current | Accepting new patients | |
| Mayo Clinic Jacksonville | Current | Accepting new patients | |
| Wake Forest University Health Sciences | Current | 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
- 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.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1790772317
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
-
- Obstetrics & Gynecology Physician
- Charlotte, NC
- NPI 1275774333
-
- Community Based Hospice Care Agency
- Statesville, NC
- NPI 1336243997
-
- Medical Oncology Physician
- Indian Land, SC
- NPI 1669738829
NC
-
- Home Infusion Therapy Pharmacy
- Jacksonville, FL
- NPI 1003510116
-
- Surgical Critical Care Physician
- Charlotte, NC
- NPI 1699979732
-
- Community/Retail Pharmacy
- Charlotte, NC
- NPI 1982710554
-
- Critical Care Medicine (Internal Medicine) Physician
- Concord, NC
- NPI 1144657636
-
- Rehabilitation Hospital Unit
- Charlotte, NC
- NPI 1962987131
-
- Family Medicine Physician
- Whiteville, NC
- NPI 1518263268
-
- Family Medicine Physician
- Tabor City, NC
- NPI 1629318886
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.