MR. LANCE LINCOLN PRIDE PA NPI 1437432036

NPI Information

NPI: 1437432036
Provider Name: MR. LANCE LINCOLN PRIDE, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
601 JOHN ST STE M-460
KALAMAZOO, MI
ZIP 49007
Phone: (269) 341-7333
Get Directions

MR. Lance Lincoln Pride, PA is a medical physician assistant in Kalamazoo, MI with 13 years of experience. MR. Lance Lincoln Pride, PA NPI is 1437432036. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

601 JOHN ST STE M-460
KALAMAZOO, MI
ZIP 49007-355
Phone: (269) 341-7333
Fax: (269) 341-7371

The NPI 1437432036 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/21/2011 and was last updated on 11/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	5601006118	MICHIGAN	No
2	363AM0700X	Physician Assistant	Medical	5601006118	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	VV9406A	OTHER	VIRGINIA	MEDICARE PTAN
2	14374322036	MEDICAID	VIRGINIA
3	10111084P	OTHER	VIRGINIA	SENTARA HEALTH PLANS
4	14374322036	OTHER	VIRGINIA	TRICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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