Individual provider Active NPI

Lisa A Scott, NP-C

  • Family Nurse Practitioner
  • Lake Saint Louis, MO
National Provider Identifier
1326387887
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012039956 Issued in MO
Practice address
6261 Ronald Reagan Dr Ste B19
Lake Saint Louis, MO 63367-2665
Phone
(636) 561-3021
Fax
(636) 561-3022
NPI assigned
Feb 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2012039956 MO Primary

Addresses

Primary practice location

6261 Ronald Reagan Dr Ste B19
Lake Saint Louis, MO 63367-2665

Mailing address

670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141-8573
Phone (636) 561-3021

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130524000174 MO Practitioner - Nurse Practitioner 8123266533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

6261 Ronald Reagan Dr
Suite B19
Lake Saint Louis, MO 63367-2665
Phone (636) 561-3021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2012039956MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince May 6, 2024 Accepting new patients
Physician Groups LC CurrentSince May 6, 2024 Accepting new patients

Locations

6261 Ronald Reagan Dr
Ste B19
Lake St Louis, MO 63367
Phone (636) 561-3021

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

660 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 463-6950

1110 Highlands Plaza Dr E
Ste 280
Saint Louis, MO 63110
Phone (314) 273-0195

670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 953-8250

Organizations & group practices 2

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": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1326387887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR",
            "address_2": "STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "636-561-3021",
            "fax_number": "636-561-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6261 RONALD REAGAN DR STE B19",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633672665",
            "telephone_number": "636-561-3021",
            "fax_number": "636-561-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-04",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012039956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6261 Ronald Reagan Dr Ste B19",
            "city": "Lake Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633672665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.