Active NPI
Lola Winn O'Renick, PH.D.
- Clinical Psychologist
- Blue Springs, MO
National Provider Identifier
1699768846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 01736
- Practice address
- 1004 SW 22ND St
Blue Springs, MO 64015-4752 - Phone
- (816) 456-4252
- NPI assigned
- Aug 23, 2005
- Last updated
- Nov 17, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 01736 | MO | Primary |
Addresses
Primary practice location
1004 SW 22ND St
Blue Springs, MO 64015-4752
Mailing address
1004 SW 22ND St
Blue Springs, MO 64015-4752
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22009014 | Other | MO | BLUE CROSS BLUE SHIELD |
| 498502400 | Medicaid | MO | |
| 758502405 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051114001100 | MO | Practitioner - Clinical Psychologist | 0547288219 | Practice locations: Blue Springs, MO |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01736 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353110400000",
"number": "1699768846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1004 SW 22ND ST",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640154752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1004 SW 22ND ST",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640154752",
"telephone_number": "816-456-4252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'RENICK",
"first_name": "LOLA WINN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-23",
"last_updated": "2012-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "01736",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "22009014",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "498502400",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "758502405",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Blue Springs, MO
- Ashley Notestine, LPC
- Novus Lifecare Hospice of Missouri LLC (Novus Lifecare)
- Novus Lifecare Palliative of Kansas City LLC (Novus Lifecare)
- Cantrell O'Hare, M.S., CCC-SLP
- Lawrence O'Renick, LPC
- Gerald Wayne Ogilvie, DDS
- Linus Ogweno
- Ashley M Oldham, FNP
- Gale Bayard Oleson, MD
- Omni Emergency Medicine LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.