NPIMap

Organization Active NPI

Genesis Psychiatric Group, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1740679463
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
110205 Issued in NE
Legal business name
GENESIS PSYCHIATRIC GROUP, LLC
Practice address
2130 S 17TH St Ste 100
Lincoln, NE 68502-3750
Phone
(402) 540-6365
NPI assigned
Jan 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Authorized official

Name
Michelle Lemon, APRNNPI 1871631184
Title
Owner
Phone
(402) 540-6365

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 965 NE
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 110205 NE Primary

Addresses

Primary practice location

2130 S 17TH St Ste 100
Lincoln, NE 68502-3750

Mailing address

1920 Perkins Blvd
Lincoln, NE 68502-3934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150219002256 NE Part B Supplier - Clinic/Group Practice 3779808571 Receives reassigned benefits from 7 practitioners
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Locations

2130 S 17th St
Ste 100
Lincoln, NE 68502
Phone (402) 454-7454

2445 R St
Ste 1
Lincoln, NE 68503
Phone (402) 454-7454

2000 P St
Lincoln, NE 68503
Phone (402) 435-4044

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424304000000",
    "number": "1740679463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 PERKINS BLVD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 S 17TH ST STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023750",
            "telephone_number": "402-540-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS PSYCHIATRIC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-19",
        "last_updated": "2015-02-19",
        "status": "A",
        "authorized_official_last_name": "LEMON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-540-6365",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "965",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "110205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.