Individual provider Active NPI

Lisa Greenwalt

  • Psychiatric/Mental Health Nurse Practitioner
  • Dublin, OH
National Provider Identifier
1851948939
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
025491 Issued in OH
Practice address
525 Metro PL N Ste 100
Dublin, OH 43017-5343
Phone
(614) 339-1649
NPI assigned
Aug 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 025491 OH Primary

Addresses

Primary practice location

525 Metro PL N Ste 100
Dublin, OH 43017-5343

Mailing address

525 Metro PL N Ste 100
Dublin, OH 43017-5343
Phone (614) 339-1649

Other identifiers 1

IdentifierTypeStateIssuer
2970854MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191009002042 OH Practitioner - Nurse Practitioner 2264763085 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Viaquest Psychiatric and Behavioral Solutions LLCGroup PAC ID 1153358486, 118 clinicians

Practice addresses (Care Compare)

525 Metro PL N
Suite 300
Dublin, OH 43017-5320
Phone (855) 289-1722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025491OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
At Your Door Visiting Healthcare Services, LLC CurrentSince Jul 13, 2020 Accepting new patients
Health First Medical Center PastSince Mar 20, 2019 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26301/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1851948939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175343",
            "telephone_number": "614-339-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175343",
            "telephone_number": "614-339-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWALT",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "025491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2970854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.