Individual provider Active NPI

Lisa Julie Renner, M.D.

  • Child & Adolescent Psychiatry Physician
  • Denver, CO
National Provider Identifier
1740280726
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
33586 Issued in CO
Practice address
360 S Monroe St
Suite 250
Denver, CO 80209-3705
Phone
(303) 333-1232
Fax
(303) 333-2575
NPI assigned
Jul 29, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 33586 CO
Child & Adolescent Psychiatry Physician 2084P0804X 33586 CO Primary

Addresses

Primary practice location

360 S Monroe St
Suite 250
Denver, CO 80209-3705

Mailing address

360 S Monroe St
Suite 250
Denver, CO 80209-3705
Phone (303) 333-1232

Other identifiers 1

IdentifierTypeStateIssuer
01335868MedicaidCO

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33586COMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1740280726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S MONROE ST",
            "address_2": "SUITE 250",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093705",
            "telephone_number": "303-333-1232",
            "fax_number": "303-333-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S MONROE ST",
            "address_2": "SUITE 250",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093705",
            "telephone_number": "303-333-1232",
            "fax_number": "303-333-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNER",
        "first_name": "LISA",
        "middle_name": "JULIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "33586",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CO",
            "license": "33586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01335868",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.