DERRICK LANE, MD, LLC (NPI# 1750620191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750620191 |
| Entity Type | Organization |
| Organization Name | DERRICK LANE, MD, LLC |
| Practice Address |
818 Forsyth St Macon GA 31201-2139 |
| Mailing Address |
Po Box 28170 Macon GA 31221-8170 |
| Practice Telephone | 4786337010 |
| Practice Fax Number | 4786337585 |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2013-02-05 |
| Authorized Official Name | DR. DERRICK LANE (OWNER) |
| Authorized Official Telephone | 4783351365 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 052594 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
818 FORSYTH ST |
| City | MACON |
| State | GA |
| Zip Code | 31201-2139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922456300 | K.v. Panchapakasan, M.d. PC | Emergency Medicine | 818 Forsyth St, Macon, GA 31201-2139 | 2016-05-26 |
| 1477921849 | Katrina Bell | Nurse Practitioner | 818 Forsyth St, Macon, GA 31201-2139 | 2015-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497393953 | Umerah Family Practice LLC | Family Medicine | 112 Arkwright Lndg Ste B, Macon, GA 31210-1364 | 2019-12-16 |
| 1992267892 | Andel Anthony Higgins | Family Medicine | 3780 Eisenhower Parkway, Macon, GA 31206 | 2019-04-01 |
| 1578025300 | Shail Patel | Family Medicine | 3780 Eisenhower Pkwy Ste 1, Macon, GA 31206-0801 | 2019-04-01 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1255779351 | Kristopher K Mcjenkin | Family Medicine | 105 Bass Plantation Dr, Apt 607, Macon, GA 31210-5735 | 2013-06-11 |
| 1215182977 | Unlimited Medical Solutions, Inc. | Family Medicine | 3200 Riverside Dr Bldg B, Macon, GA 31210-2550 | 2008-11-22 |
| 1144474784 | Jack Fernando Menendez | Family Medicine | 376 Rogers Ave, Macon, GA 31204-2506 | 2008-11-10 |
| 1255504098 | Veera Pavuluri | Family Medicine | 132 Madison North Dr, Macon, GA 31220-7626 | 2008-04-11 |
| 1871770412 | Albert Warren Jr. | Family Medicine | 1339 Gray Hwy, Macon, GA 31211-1903 | 2008-01-25 |
| 1477738334 | Bibb Family Practice Associates PC | Family Medicine | 718 1st St, Macon, GA 31201-6840 | 2008-01-09 |
| Find all providers in MACON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.