JORDAN BRYAN LANE DO
NPI 1639758006
Dermatology in West Plains, MO

Q: What is Jordan Lane's NPI number?

The NPI number for Jordan Lane is 1639758006. It was assigned to this individual provider in the NPPES registry on April 5, 2021.

Q: What is Jordan Lane's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Jordan Lane was last updated on July 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.

Active since April 05, 2021PECOS EnrolledAccepts Medicare Assignment

1100 N KENTUCKY AVE, WEST PLAINS, MO 65775(417) 256-9111 Get Directions Write a Review

NPPES record last updated: July 6, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 6, 2025, Aug 8, 2022, Apr 5, 2021 (3 updates tracked since 2021).

On this page

About Jordan Bryan Lane Do NPPES

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

JORDAN BRYAN LANE DO (NPI 1639758006) is an individual dermatology provider in West Plains, Missouri, licensed in Missouri (2022025223) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, is affiliated with Ozarks Healthcare, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2021).

NPPES Registry Identity

NPI1639758006

Entity TypeIndividualMale

Primary Taxonomy207N00000X

Provider Legal NameJORDAN BRYAN LANECredential: DO

Location Address1100 N KENTUCKY AVEWest Plains, MO 65775-2029

Mailing Address1100 N Kentucky AveWest Plains, MO 65775-2029 · (417) 256-9111

Phone(417) 256-9111

Sole ProprietorYes

Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2021

Enumeration DateApril 5, 2021

Last NPPES UpdateJuly 6, 20253 updates tracked since enumeration

NPPES CertifiedJuly 6, 2025

✔ NPI 1639758006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in MO · 2022025223

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

1100 N KENTUCKY AVE, West Plains, MO 65775

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jordan Bryan Lane Do 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 ID7113439894

PECOS Enrollment IDI20250626003000

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.

Hospital Affiliations CMS Care Compare

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

Ozarks Healthcare

Acute Care Hospitals · West Plains, MO

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260078

Location1100 Kentucky AveWest Plains, MO 65775 · Howell County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65775 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

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$65.71 typical visit price

range $16.30 – $131.05

Typical copayment $16.42 (range $4.07 – $32.76)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

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