Lisa A Koester-Wiedemann, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

134512 Issued in MO

Practice address

4205 Forest Park Ave
Div Im Nephrology
Saint Louis, MO 63108-2810

Phone

(314) 286-0800

Fax

(314) 286-0855

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Washington UniversityGroup PAC ID 9830008770, shared by 49 NPIs, 2,968 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.2 of 100Reported as group

Quality

71.6

Promoting interoperability

100

Improvement activities

40

Cost

75.75

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Washington University

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saint Louis, MO
  • NPI 1841221116
  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1992746903
  Medicare reassignment NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1134169568
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1184642662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-286-0800",
            "fax_number": "314-286-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 FOREST PARK AVE",
            "address_2": "DIV IM NEPHROLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082810",
            "telephone_number": "314-286-0800",
            "fax_number": "314-286-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOESTER-WIEDEMANN",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "134512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425146008",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4205 Forest Park Ave",
            "address_2": "Div IM Nephrology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631082810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara M Koenig, WHNP
• Shannon Kelly Koenigsfeld, PLPC
• Jeffrey R Koenitzer, MD
• Charlene Velma Koepke, CRNA
• Haley M Koepp, PMHNP-BC
• Rachel Koester, IBCLC
• Cathy Ware Koetting, CPNP, NP-C
• Julia Lynne Kofkoff, D.D.S.
• Lauren Kofron, LPC
• William Kogel

• Adult Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.