Wanita Lister, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2013029766 Issued in MO

Practice address

1317 W Broadway St
Bolivar, MO 65613-1814

Phone

(417) 326-7250

NPI assigned

Jul 10, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ozarks Resource GroupGroup PAC ID 6002068723, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ozarks Resource Group

  • Federally Qualified Health Center (FQHC)
  • Hermitage, MO
  • NPI 1639421050
  Medicare reassignment Care Compare group NPD
• Polk County Health Center

  • Public Health or Welfare Agency
  • Bolivar, MO
  • NPI 1265556849
  Medicare reassignment NPD
• Ozarks Resource Group

  • Federally Qualified Health Center (FQHC)
  • Urbana, MO
  • NPI 1659942027
  NPD

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

• Citizens Memorial Hospital District

  • General Acute Care Hospital
  • Bolivar, MO
  • NPI 1003981549
  Care Compare affiliation

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1467893172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4046",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658084046",
            "telephone_number": "417-269-5712",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 W BROADWAY ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656131814",
            "telephone_number": "417-326-7250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3315 S Campbell Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658074914",
            "country_code": "US",
            "telephone_number": "417-886-2219",
            "fax_number": "417-886-2293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISTER",
        "first_name": "WANITA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2006021735",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013029766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James G Liesen, DO
• Melissa Lightfoot
• Lighthouse of Hope, LLC
• Greg Link, DO
• Tammy Lynn Lippincott, L.M.T
• Nicholas Allen Locke, NP-C
• Loehr Health Center Bolivar LLC
• Matthew Dean Loyd
• Wendy M Lueckenhoff, SLP
• Krista Lutz, CD, CBE, CLC

• Family Nurse Practitioner in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.