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Active NPI 1275902520 Individual Practitioner Male Practitioner

Jack Lane , PTA

Skilled Nursing Facility • Lewiston, ID

Professional Overview & Biography Verified Profile Summary

Jack Lane, PTA is a registered healthcare professional specializing in Skilled Nursing Facility in Lewiston, ID. Practice services are available at 615 29TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

615 29th St

Lewiston, ID 835013341

Telephone 2089854722

Specialty Benchmarks & Practice Insights

Comparative analytics for Skilled Nursing Facility in Lewiston, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Lewiston, ID (4 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Skilled Nursing Facility Primary Specialty

NUCC Taxonomy Code: 314000000X

State License ID PTA-3672

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 16, 2015

NPI status registered as active in NPPES database

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Updated Practice Location September 16, 2015

Registered at 615 29TH ST, LEWISTON, ID 835013341 (Tel: 2089854722)

📍
Updated Business Mailing Address September 16, 2015

Registered at 615 29TH ST, LEWISTON, ID 835013341 (Tel: 2089854722)

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Provider Name / Credentials Updated September 16, 2015

Recorded as JACK LANE, PTA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 16, 2015

Skilled Nursing Facility (License #PTA-3672 in ID)

🟢
Initial NPI Registration & Enumeration September 16, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1275902520
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 16, 2015
Last Update: September 16, 2015
Sole Proprietor: Yes

Mailing Address

615 29th St

Lewiston, ID 835013341

Phone: 2089854722

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.