Lauri Green M.D. S.C.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

38185 Issued in WI

Legal business name

LAURI GREEN M.D. S.C.

Practice address

1177 Quail CT
Suite 101
Pewaukee, WI 53072-3790

Phone

(262) 695-1212

Fax

(262) 695-1919

NPI assigned

Jul 30, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lauri Theresa Green, M.D.NPI 1922045970

Title

Owner

Phone

(262) 695-1212

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lauri Theresa Green, M.D.

  • Psychiatry Physician
  • Pewaukee, WI
  • NPI 1922045970
  Authorized official Same address or phone

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710992268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 QUAIL CT",
            "address_2": "SUITE 101",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723790",
            "telephone_number": "262-695-1212",
            "fax_number": "262-695-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 QUAIL CT",
            "address_2": "SUITE 101",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723790",
            "telephone_number": "262-695-1212",
            "fax_number": "262-695-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURI GREEN M.D. S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LAURI",
        "authorized_official_middle_name": "THERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-695-1212",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "38185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32265500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.