Lisa M Poulos

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

950023 Issued in NC

Practice address

603 Dolley Madison Rd Ste 100
Greensboro, NC 27410-4282

Phone

(336) 632-3505

Fax

(336) 665-6188

NPI assigned

Jun 3, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Maryland School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Triad Psychiatric and Counseling Center PAGroup PAC ID 3173590882, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.poulos.1@18773.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Triad Psychiatric and Counseling Center PA

  • Psychiatry Physician
  • Greensboro, NC
  • NPI 1285671602
  Medicare reassignment Care Compare group NPD
• Greenbrook TMS Winston-Salem LLC

  • Clinic/Center
  • Winston Salem, NC
  • NPI 1659879104
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1174561740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 DOLLEY MADISON RD STE 100",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104282",
            "telephone_number": "336-632-3505",
            "fax_number": "336-665-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 DOLLEY MADISON RD STE 100",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104282",
            "telephone_number": "336-632-3505",
            "fax_number": "336-665-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOS",
        "first_name": "LISA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NC",
            "license": "950023",
            "primary": false
        },
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NC",
            "license": "950023",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "950023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larae Vernita Potter
• Lexis Kay Potter
• Patricia L Potter, M.D.
• Rhonda Potts, LPC,LCAS,,LP
• Abby Weaver Poulos, OTR/L
• Allison Marsh Pow, PH.D., LCMHCS
• Demetria Powell-Harrison, LCSW
• Alvin C Powell, MD
• Alvin Caldwell Powell Jr.
• Ana M Powell, LMBT

• Psychiatric/Mental Health Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.