JORDAN BRYAN LANE (DO) – Dermatology Physician, NPI 1639758006
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
337 DERMATOLOGY in MO
Provider Addresses for JORDAN BRYAN LANE (DO)
315 S Osteopathy Ave
Kirksville, MO 635016401
Phone: (660) 785-1000
Type: Location
1100 N KENTUCKY AVE
WEST PLAINS, MO 657752029
Phone: (417) 256-9111
Type: Mailing
315 S OSTEOPATHY AVE
KIRKSVILLE, MO 635016401
Phone: (660) 785-1000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 185 Open Payments records for all available years, with a total value of $5,343.
Total Amount is formed as General ($5,343) + Research ($0) + Ownership ($0) = $5,343.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($619).
Total Amount
$5,343
General + Research + Ownership
Payments
185
Total payment records
General Amount
$5,343
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $619 |
| Regeneron Healthcare Solutions, Inc. | $579 |
| Dermavant Sciences, Inc. | $467 |
| E.R. Squibb & Sons, L.L.C. | $348 |
| GENZYME CORPORATION | $313 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-06-26
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250626003000 | I | Dermatology | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63501)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MO | |
| Physician Assistant | OK | |
| - | IL | |
| Internal Medicine, Rheumatology | MO | |
| A N E S T H E S I O L O G Y | MO | |
| - | MO | |
| - | IL | |
| Nurse Practitioner | AR | |
| - | MO | |
| Emergency Medicine | MO |
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