Individual provider Active NPI

Lisa Cathalene Greenfield

  • Peer Specialist
  • Portland, OR
National Provider Identifier
1619443280
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
18-CRM-330 Issued in OR
Practice address
1949 SE 122ND Ave
Portland, OR 97233-1303
Phone
(503) 253-5954
NPI assigned
Oct 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 18-CRM-330 OR Primary

Addresses

Primary practice location

1949 SE 122ND Ave
Portland, OR 97233-1303

Mailing address

232 NW 6TH Avenue
Attn: Credentialing
Portland, OR 97209
Phone (503) 501-5641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18-CRM-330ORMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1619443280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 NW 6TH AVENUE",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97209",
            "telephone_number": "503-501-5641",
            "fax_number": "503-294-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 SE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331303",
            "telephone_number": "503-253-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENFIELD",
        "first_name": "LISA",
        "middle_name": "CATHALENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "18-CRM-330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.