Lori Payne

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2010022198 Issued in MO

Practice address

5551 Winghaven Blvd
Suite 240
O Fallon, MO 63368-3617

Phone

(636) 561-5561

Fax

(636) 561-5557

NPI assigned

Nov 18, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Winghaven Pediatrics LLC

  • Pediatrics Physician
  • O Fallon, MO
  • NPI 1568596922
  NPD (past)

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1336545391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5551 WINGHAVEN BLVD",
            "address_2": "SUITE 240",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683617",
            "telephone_number": "636-561-5561",
            "fax_number": "636-561-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 WINGHAVEN BLVD",
            "address_2": "SUITE 240",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683617",
            "telephone_number": "636-561-5561",
            "fax_number": "636-561-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "LORI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2010022198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Edward Patterson, CRNFA, CNOR
• Billi J Patzius, PHD
• Andrew Jonathan Pawloski
• Maggie Mae Pawlowski, PT, DPT
• Paws and Play Counseling LLC
• Richi Michelle Peer, CCC-SLP
• Pelican Valley Services LLC
• Lara Ann Penn, FNP
• Enmanuel Jose Perez, MD
• Julia Perine, M.A., CCC-SLP

• Pediatric Nurse Practitioner in O Fallon, MO
• Providers in O Fallon, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.