NPI age
10 years
Enumerated 2015-09-16
● Active
Type 1 · Individual
MR. Jack Lane IV, PTA
Lane is 1 of 14 skilled nursing facility providers in Lewiston and 1 of 173 in Idaho.
Primary specialty
Skilled Nursing Facility
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2015-09-16
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 173 active skilled nursing facility providers in Idaho.
NPI age
10 years
↓ 7 yr below median (17 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
0
6% of peers hold subspecialties
NPI lifetime · 2015 → 2026
2015-09Enumerated in NPPES
2015
2026
Where they practice
Practice location
615 29th St
Lewiston, ID 835013341
Mailing address
615 29th St
Lewiston, ID 835013341
Specialties
-
Skilled Nursing Facility Primary(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...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.