Individual provider Active NPI

Niansen Liu, M.D.

  • Psychiatry Physician
  • Cleveland, TN
National Provider Identifier
1679578371
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
36406 Issued in TN
Practice address
3555 Keith St NW
Ste 102
Cleveland, TN 37312-4375
Phone
(423) 728-2282
Fax
(423) 728-2234
NPI assigned
Jun 17, 2005
Last updated
Dec 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 36406 TN Primary

Addresses

Primary practice location

3555 Keith St NW
Ste 102
Cleveland, TN 37312-4375

Mailing address

3555 Keith St NW
Ste 102
Cleveland, TN 37312-4375
Phone (423) 728-2282

Other identifiers 2

IdentifierTypeStateIssuer
4175788OtherBCBS
38783611MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050318000173 TN Practitioner - Psychiatry 8123073517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland Behavioral Health, PLLCGroup PAC ID 4183701576, 2 clinicians

Practice addresses (Care Compare)

3555 Keith St NW
Suite 102
Cleveland, TN 37312-4375
Phone (423) 728-2282

Merit-based Incentive Payment System (MIPS)

Final score
23.4 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36406TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Behavioral Health, PLLC CurrentSince Apr 9, 2008 Accepting new patients
Cleveland Medical Clinic Inc Past Accepting new patients
Cleveland Counseling Associates, P.C. Past Accepting new patients

Locations

3555 Keith St NW
Ste 102
Cleveland, TN 37312
Phone (423) 728-2282

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1679578371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 KEITH ST NW",
            "address_2": "STE 102",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124375",
            "telephone_number": "423-728-2282",
            "fax_number": "423-728-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 KEITH ST NW",
            "address_2": "STE 102",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124375",
            "telephone_number": "423-728-2282",
            "fax_number": "423-728-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "NIANSEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "36406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4175788",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38783611",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.