Lisa Joyce Keller Salvaggio, PSY.D., LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP6349 Issued in MN

Practice address

120 Labree Ave S
Thief River Falls, MN 56701-2819

Phone

(218) 683-4349

NPI assigned

Sep 16, 2013

Reactivated

Sep 21, 2023

Last updated

Nov 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Lisa Joyce Keller Salvaggio Professional name

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Health Network NorthGroup PAC ID 8022206663, 114 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.22 of 100Reported as group

Quality

90.28

Promoting interoperability

100

Improvement activities

40

Cost

72.7

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Sanford Health Network North

  dba Sanford Health Southeast Campus

  • Multi-Specialty Clinic/Center
  • Thief River Falls, MN
  • NPI 1386047355
  Medicare reassignment Care Compare group NPD
• Sanford Health Network North

  dba Sanford Thief River Falls

  • Family Medicine Physician
  • Thief River Falls, MN
  • NPI 1144401514
  NPD

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1346676897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LABREE AVE S",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012819",
            "telephone_number": "218-683-4349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3615 17th St S",
            "address_purpose": "LOCATION",
            "city": "Moorhead",
            "state": "MN",
            "postal_code": "565607050",
            "country_code": "US",
            "telephone_number": "701-720-7222",
            "fax_number": "701-532-0428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER SALVAGGIO",
        "first_name": "LISA",
        "middle_name": "JOYCE",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "deactivation_date": "2023-09-07",
        "reactivation_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENROLLMENT PART B",
            "identifier": "H400917182",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "KELLER SALVAGGIO",
            "middle_name": "JOYCE",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Danielle Alene Jordan, PH.D., L.P.
• Andrea Marie Jorgenson, CNP
• Katherine Joseph, MD
• Sherrie Ann Kahn, PSYD
• Kenton Dayle Kainz, D.C.
• Christopher Lee Kelly, O.D.
• Steven Charles Keogh, DR OF CHIROPRACTIC
• Steven Lee Keogh, D.C.
• Jawad H Khan, MD
• Wendy Lyn Kjersten

• Psychologist in Thief River Falls, MN
• Providers in Thief River Falls, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.