Individual provider Active NPI

Lori Wenz, NP

  • Nurse Practitioner
  • Grand Junction, CO
National Provider Identifier
1679961783
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95001728 Issued in CA
Practice address
551 Grand Ave Ste 302
Grand Junction, CO 81501-2694
Phone
(970) 773-5777
NPI assigned
Dec 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 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 839807 CA
Nurse Practitioner 363L00000X NP95001728 CA Primary

Addresses

Primary practice location

551 Grand Ave Ste 302
Grand Junction, CO 81501-2694

Mailing address

2820 Vestrella Dr
Modesto, CA 95356-9377
Phone (209) 505-9399

Other practice location 1

1444 Florida Ave
Suite 202
Modesto, CA 95350-4400
Phone (209) 524-1264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180118002835 CA Practitioner - Nurse Practitioner 1254602626
I20200428000169 CO Practitioner - Nurse Practitioner 1254602626 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95001728CAMDNurse Practitioner
95001728CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Apr 17, 2020 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Apr 17, 2020 Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

2440 N 11th St
Grand Junction, CO 81501
Phone (970) 243-0900

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

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.

NPI Registry JSON

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

{
    "created_epoch": "1419552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1679961783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 VESTRELLA DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569377",
            "telephone_number": "209-505-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 GRAND AVE STE 302",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012694",
            "telephone_number": "970-773-5777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1444 Florida Ave",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953504400",
            "country_code": "US",
            "telephone_number": "209-524-1264",
            "fax_number": "209-524-1306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENZ",
        "first_name": "LORI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-26",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "839807",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95001728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.