Lisa Marie Wagner, APN NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0993561-NP Issued in CO

Practice address

249 Kodiak Dr Unit 201
Basalt, CO 81621-8140

Phone

(970) 618-8796

Fax

(970) 645-3168

NPI assigned

Nov 30, 2017

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.

• Thrive Aspen LLC

  • General Practice Physician
  • Basalt, CO
  • NPI 1528817780
  NPD Authorized official

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1346754249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 KODIAK DR UNIT 201",
            "city": "BASALT",
            "state": "CO",
            "postal_code": "816218140",
            "telephone_number": "970-618-8796",
            "fax_number": "970-645-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 KODIAK DR UNIT 201",
            "city": "BASALT",
            "state": "CO",
            "postal_code": "816218140",
            "telephone_number": "970-618-8796",
            "fax_number": "970-645-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "APN NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0993561-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valley View Hospital Association
• Valley View Hospital Association
• Valley View Hospital Association
• Valley View Hospital Association
• Megan Verros, MSW MPH
• Tracie E Walterscheid, PA
• Elizabeth Cockrill Ward, CMT
• Lindsay Williams, RDH
• Win Hbo
• Win Health Institute, LLC

• All providers in Basalt, CO
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.