Individual provider Active NPI

Emily N Lenzner, FNP

  • Nurse Practitioner
  • Saint Peters, MO
National Provider Identifier
1417686387
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2022018218 Issued in MO
Practice address
201 BJC Saint Peters Dr Ste 200
Saint Peters, MO 63376-3386
Phone
(636) 916-9615
Fax
(636) 916-9850
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2022018218 MO Primary

Addresses

Primary practice location

201 BJC Saint Peters Dr Ste 200
Saint Peters, MO 63376-3386

Mailing address

660 Mason Ridge Center Dr Ste 300
Saint Louis, MO 63141-8512
Phone (314) 448-3791

Other identifiers 1

IdentifierTypeStateIssuer
2022018218OtherMOMISSOURI STATE BOARD OF NUJRSING

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://nppes.cms.hhs.gov/webhelp/nppeshelp/HEALTH%20INFORMATION%20EXCHANGE.html Health Information Exchange (HIE)
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
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
I20220810003372 MO Practitioner - Nurse Practitioner 6800279779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
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)

201 BJC Saint Peters Dr
Suite 200
Saint Peters, MO 63376-3386
Phone (636) 916-9615

Hospital & facility affiliations

  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince Feb 24, 2024 Accepting new patients
Physician Groups LC CurrentSince Feb 24, 2024 Accepting new patients

Locations

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

201 Bjc Saint Peters Dr
Ste 200
Saint Peters, MO 63376
Phone (636) 916-9615

965 Mattox Dr
Sullivan, MO 63080
Phone (573) 468-7054

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1417686387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 MASON RIDGE CENTER DR STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418512",
            "telephone_number": "314-448-3791",
            "fax_number": "314-996-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BJC SAINT PETERS DR STE 200",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633763386",
            "telephone_number": "636-916-9615",
            "fax_number": "636-916-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENZNER",
        "first_name": "EMILY",
        "middle_name": "N",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2022018218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI STATE BOARD OF NUJRSING",
            "identifier": "2022018218",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://nppes.cms.hhs.gov/webhelp/nppeshelp/HEALTH%20INFORMATION%20EXCHANGE.html",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "240 College St Ste 100",
            "city": "Bourbon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "654418308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "965 Mattox Dr",
            "city": "Sullivan",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630802365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "201 Bjc Saint Peters Dr Ste 200",
            "city": "Saint Peters",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633763386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.