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LAWANNA LANAE MCGUIRE APRN
NPI 1083262349
Nurse Practitioner - Family in Pikeville, KY

Active since August 29, 2019PECOS EnrolledAccepts Medicare Assignment
86.86/100
CMS Quality Rating
911 BYPASS RD BLDG A, PIKEVILLE, KY 41501(606) 218-3516(606) 218-4540 Get Directions Write a Review

NPPES record last updated: September 22, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 22, 2022, Apr 29, 2021, Jan 12, 2021 and 1 more (4 updates tracked since 2019).

About Lawanna Lanae Mcguire Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAWANNA LANAE MCGUIRE APRN (NPI 1083262349) is an individual family provider in Pikeville, Kentucky, licensed in Kentucky (3013701) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS, is affiliated with Pikeville Medical Center, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1083262349
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameLAWANNA LANAE MCGUIRECredential: APRN
Location Address911 BYPASS RD BLDG APikeville, KY 41501-1689
Mailing AddressPo Box 432Pikeville, KY 41502-0432 · (606) 218-3516 · Fax (606) 218-4540
Phone(606) 218-3516
Fax(606) 218-4540
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateAugust 29, 2019
Last NPPES UpdateSeptember 22, 20224 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2022
✔ NPI 1083262349 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in KY · 3013701
911 BYPASS RD BLDG A, Pikeville, KY 41501
Open in Google Maps ↗

Other Identifiers 7

Other2282825KY · Wellcare Of Ky Provider Id Number
Medicaid7100686320KY
OtherCS2027500198Caresource Provider Id Number
OtherPDZ000000623080Aetna Better Health Of Ky Provider Id Number
Other000001412352Anthem Provider Id Number
Other14604528Caqh Provider Id
Other7473477United Healthcare Provider Id Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lawanna Lanae Mcguire Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678900099
PECOS Enrollment IDI20200225001534
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Lawanna Mcguire reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pikeville Medical Center Inc.
1.4 mi
Clinic/Center
254 CASSIDY BLVD
Pikeville, KY 41501
  • Reassigned Medicare billing, Kentucky enrollment
  • 579 clinicians in this Medicare group
NPI 1710207865 (606) 437-0123
Integrated Wound Care Kentucky PLLC
21 mi
Primary Care
60 PHILLIPS BRANCH RD
Phelps, KY 41553
  • Reassigned Medicare billing, Kentucky enrollment
  • 7 clinicians in this Medicare group
NPI 1144970641 (718) 963-3495
Commonwealth Pain Associates, PLLC
177 mi
Interventional Pain Medicine
120 EXECUTIVE PARK
Louisville, KY 40207
  • Reassigned Medicare billing, Kentucky enrollment
  • 193 clinicians in this Medicare group
NPI 1306280177 (502) 855-7200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
108 services67 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
29 services27 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
20 services15 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
20 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Pikeville Medical Center

Acute Care Hospitals · Pikeville, KY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180044
Location911 Bypass RoadPikeville, KY 41501 · Pike County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.86/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.39
Promoting Interoperability100
Improvement Activities40
Cost70.65

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. WHITNEY P. BURTON PA-C
Physician Assistant
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-2201
DR. SHRAVANTI PONGALI MUTHU MD, MPH
Hospitalist
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-3500
AMY O JOHNSON MD
Surgery
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-2205
MATTHEW SEXTON M.D.
Anesthesiology (Critical Care Medicine)
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-3500
CAITLIN VICTORIA BERNIECE COLLIER
Nurse Practitioner (Family)
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-2208
BRIANNA I COLEMAN
Nurse Practitioner (Family)
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-2201
EMUESIRI CATHERINE OVWIGHO MD
Hospitalist
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-3500
TRULENA BENNER CRNA
Nurse Anesthetist, Certified Registered
911 BYPASS RD BLDG A
PIKEVILLE, KY 41501
Pike County (606) 430-3500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lawanna Mcguire's NPI number?

The NPI number for Lawanna Mcguire is 1083262349. It was assigned to this individual provider in the NPPES registry on August 29, 2019.

Where is Lawanna Mcguire located?

Lawanna Mcguire practices at 911 Bypass Rd Bldg A, Pikeville, KY 41501. The listed phone number is (606) 218-3516.

What is Lawanna Mcguire's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Lawanna Mcguire enrolled in Medicare?

Yes. Lawanna Mcguire is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Lawanna Mcguire's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lawanna Mcguire reassigns Medicare benefits to 3 organizations: Pikeville Medical Center Inc. (Pikeville, KY), Integrated Wound Care Kentucky PLLC (Phelps, KY) and Commonwealth Pain Associates, PLLC (Louisville, KY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lawanna Mcguire's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lawanna Mcguire accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee, Anthem Blue Cross and Blue Shield and CareSource list Lawanna Mcguire as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Lawanna Mcguire affiliated with any hospitals?

According to CMS data, Lawanna Mcguire is affiliated with Pikeville Medical Center.

When was this NPI record last updated?

The NPPES record for Lawanna Mcguire was last updated on September 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.