Individual provider Active NPI

Maeghan Ashlee Wegener, APRN, FNP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1457995466
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2019042817 Issued in MO
Practice address
3009 N Ballas Rd Ste 260C
Saint Louis, MO 63131-2382
Phone
(314) 996-7940
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2019042817 MO
Nurse Practitioner 363L00000X 2019042817 MO Primary

Addresses

Primary practice location

3009 N Ballas Rd Ste 260C
Saint Louis, MO 63131-2382

Mailing address

3009 N Ballas Rd Ste 260C
Saint Louis, MO 63131-2382
Phone (314) 996-7940

Other practice location 1

124 Chesterfield Towne Ctr
Chesterfield, MO 63005-1230
Phone (314) 254-2400

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
I20230426002646 MO Practitioner - Nurse Practitioner 3173988185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

3009 N Ballas Rd
Suite 260C
Saint Louis, MO 63131-2382
Phone (314) 996-7940

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019042817MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince May 1, 2023 Accepting new patients
Physician Groups LC CurrentSince May 1, 2023 Accepting new patients
Revital LLC PastSince Apr 1, 2023 Accepting new patients

Locations

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

3009 N Ballas Rd
Ste 260C
Saint Louis, MO 63131
Phone (314) 996-7190

3844 S Lindbergh Blvd
Ste 220
Saint Louis, MO 63127
Phone (314) 569-2620

3023 N Ballas Rd
Ste 200D
Saint Louis, MO 63131
Phone (314) 996-7272

Organizations & group practices 3

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": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1457995466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 260C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312382",
            "telephone_number": "314-996-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 260C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312382",
            "telephone_number": "314-996-7940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 Chesterfield Towne Ctr",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630051230",
            "country_code": "US",
            "telephone_number": "314-254-2400",
            "fax_number": "314-787-2141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEGENER",
        "first_name": "MAEGHAN",
        "middle_name": "ASHLEE",
        "credential": "APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019042817",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2019042817",
            "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": "3009 N Ballas Rd Ste 260C",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.