Individual provider Active NPI

Lisa A Pattison, PHD

  • Psychologist
  • Grand Island, NE
National Provider Identifier
1922048859
Registry record updated May 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
325 Issued in NE
Practice address
3280 Woodridge Blvd
Suite 200
Grand Island, NE 68801-5194
Phone
(308) 382-1764
Fax
(308) 395-3730
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 325 NE Primary

Addresses

Primary practice location

3280 Woodridge Blvd
Suite 200
Grand Island, NE 68801-5194

Mailing address

PO Box 5194
3280 Woodridge Blvd Suite 200
Grand Island, NE 68802-5194
Phone (308) 382-1764

Other identifiers 1

IdentifierTypeStateIssuer
47078358200MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20080612000095 NE Practitioner - Clinical Psychologist 7618048000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3280 Woodridge Blvd
Suite 200
Grand Island, NE 68801-7483
Phone (308) 382-1764

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
325NEMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling, P.C. Psychologist CurrentSince Jan 5, 2009 Accepting new patients

Locations

3280 Woodridge Blvd
Ste 200
Grand Island, NE 68801
Phone (308) 380-4136

Organizations & group practices 1

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1922048859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5194",
            "address_2": "3280 WOODRIDGE BLVD SUITE 200",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025194",
            "telephone_number": "308-382-1764",
            "fax_number": "308-395-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 WOODRIDGE BLVD",
            "address_2": "SUITE 200",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688015194",
            "telephone_number": "308-382-1764",
            "fax_number": "308-395-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTISON",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47078358200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.