Individual provider Active NPI

Lorie S Dorn, AU.D.

  • Audiologist
  • Green Bay, WI
National Provider Identifier
1750424883
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
411-156 Issued in WI
Practice address
923 Eliza St
Green Bay, WI 54301-3234
Phone
(920) 965-4800
Fax
(920) 431-7024
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 411-156 WI Primary

Addresses

Primary practice location

923 Eliza St
Green Bay, WI 54301-3234

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7226

Other identifiers 2

IdentifierTypeStateIssuer
507105OtherWIMEDICARE PTAN
41144000MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081013000034 WI Practitioner - Qualified Audiologist 0840368288 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

923 Eliza St
Green Bay, WI 54301-3234
Phone (920) 965-4800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
411-156WIMDAudiologist
411WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Mar 1, 2016 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Jan 3, 2019 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Mar 1, 2016 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Jan 3, 2019 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

923 Eliza St
Green Bay, WI 54301
Phone (920) 965-4700

933 Waube Ln
Green Bay, WI 54304
Phone (920) 548-9500

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: ldorn32684@direct.thedacare.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1750424883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 ELIZA ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013234",
            "telephone_number": "920-965-4800",
            "fax_number": "920-431-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORN",
        "first_name": "LORIE",
        "middle_name": "S",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "411-156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "507105",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41144000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.