Jacolyn Su Lorenzo

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

060906 Issued in MO

Practice address

210 W Sunshine St # F
Springfield, MO 65807-2655

Phone

(417) 869-4744

Fax

(417) 869-4747

NPI assigned

Feb 8, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• New Medico Healthcare Corporation

  • Psychiatry Physician
  • Bolivar, MO
  • NPI 1245250091
  NPD (past)

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

{
    "created_epoch": "1581120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581120000000",
    "number": "1619509544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 209",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650650209",
            "telephone_number": "573-723-0847",
            "fax_number": "573-302-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W SUNSHINE ST # F",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658072655",
            "telephone_number": "417-869-4744",
            "fax_number": "417-869-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZO",
        "first_name": "JACOLYN",
        "middle_name": "SU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-08",
        "last_updated": "2020-02-08",
        "certification_date": "2020-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "060906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edwin Jose Lopez, O.T.R.
• Misty Renee Lopez, PA-C
• Christopher S Lorance, PSYD, LP
• Patrick K Lord, PSYD
• Jon D Lorenzino, MD
• John J Lorette, DO
• William W Lorey
• Claire Losey
• Shaun Lotter, MA
• Joshua David Lottmann, PA-C

• Registered Nurse in Springfield, MO
• Providers in Springfield, MO by specialty
• Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2020; 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.