Individual provider Active NPI

Jessica Lorenzo-Gaier, PHD

  • Psychologist
  • Apex, NC
National Provider Identifier
1992104350
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5848 Issued in NC
Practice address
2311 Energy Dr BLDG 9
Apex, NC 27502-4343
Phone
(984) 254-5635
Fax
(317) 520-8200
NPI assigned
Aug 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4816 NC
Psychologist 103T00000X 5848 NC Primary

Addresses

Primary practice location

2311 Energy Dr BLDG 9
Apex, NC 27502-4343

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

Other practice location 1

3325 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 713-7429

Other names 1

  • Jessica Anne Lorenzo Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210210000225 NC Practitioner - Clinical Psychologist 1052726734

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5848NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ad/HD Clinic at University of North Carolina Greensboro Clinical Past Accepting new patients
Uncg Psychology Clinic Psychologist Past Accepting new patients
Hopebridge LLC Psychologist Past Accepting new patients

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": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1992104350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "317-520-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 ENERGY DR BLDG 9",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024343",
            "telephone_number": "984-254-5635",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3325 Silas Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033013",
            "country_code": "US",
            "telephone_number": "336-713-7429",
            "fax_number": "336-713-7842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LORENZO-GAIER",
        "first_name": "JESSICA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4816",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "5848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LORENZO",
            "middle_name": "ANNE",
            "credential": "M.A.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Apex, NC

Sources for this page

Verify at the official NPI Registry.