Individual provider Active NPI

Lori N Greer, PSYD

  • Psychologist
  • Portage, WI
National Provider Identifier
1922042126
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
2639 New Pinery Rd
Suite 1
Portage, WI 53901-1110
Phone
(608) 742-5020
Fax
(608) 742-3641
NPI assigned
Jun 16, 2006
Last updated
Mar 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

2639 New Pinery Rd
Suite 1
Portage, WI 53901-1110

Mailing address

6010 Saddle Ridge
Portage, WI 53901
Phone (608) 745-4309

Other practice location 1

620 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-7600

Other identifiers 2

IdentifierTypeStateIssuer
13515OtherWIDEAN INSURANCE
39130900MedicaidWI

Other names 1

  • Lori N Nelson Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lgreer331515@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205000283 WI Practitioner - Clinical Psychologist 1951294719 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aspen Family CounselingGroup PAC ID 0840193157, 5 clinicians
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

2639 New Pinery Rd
Suite 1
Portage, WI 53901-1110
Phone (608) 742-5020

620 W Brown St
Waupun, WI 53963-1702
Phone (920) 926-4100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare, Inc Current Accepting new patients
Aspen Family Counseling CurrentSince Jul 10, 2005 Accepting new patients
Agnesian Healthcare Inc CurrentSince Mar 7, 2020 Accepting new patients

Locations

200 Front St
#3D
Beaver Dam, WI 53916
Phone (920) 885-2780

200 Front St
Ste 3D
Beaver Dam, WI 53916
Phone (920) 885-2780

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

2639 New Pinery Rd
Ste 1
Portage, WI 53901
Phone (608) 742-5020

620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581

Interoperability endpoints

  • Direct secure messaging: lgreer331515@direct-ehr-ssmhc.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1922042126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 SADDLE RIDGE",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "53901",
            "telephone_number": "608-745-4309",
            "fax_number": "608-742-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 NEW PINERY RD",
            "address_2": "SUITE 1",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539011110",
            "telephone_number": "608-742-5020",
            "fax_number": "608-742-3641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 W Brown St",
            "address_purpose": "LOCATION",
            "city": "Waupun",
            "state": "WI",
            "postal_code": "539631702",
            "country_code": "US",
            "telephone_number": "920-324-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREER",
        "first_name": "LORI",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN INSURANCE",
            "identifier": "13515",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39130900",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgreer331515@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "lgreer331515@direct-ehr-ssmhc.com",
            "address_1": "620 W Brown St",
            "city": "Waupun",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539631702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "620 W Brown St",
            "city": "Waupun",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539631702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "NELSON",
            "middle_name": "N",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portage, WI

Sources for this page

Verify at the official NPI Registry.