Lori A Wagner, MSN, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

3002772 Issued in KY

Practice address

2387 Professional Heights Dr Ste 180
Lexington, KY 40503-3013

Phone

(859) 967-9486

Fax

(859) 368-7780

NPI assigned

Sep 12, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 4

Other names 1

• Lori A Bromagen Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

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

University of Kentucky College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lori.wagner-bromagen.1@22715.direct.athenahealth.com

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.

• J & L Healthcare Consultants LLC

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1275520454
  Medicare reassignment Authorized official
• Kentucky Inpatient Medicine Associates, PLLC

  • Hospitalist Physician
  • Lexington, KY
  • NPI 1417915661

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1710972260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 CADEN LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405094316",
            "telephone_number": "859-797-5558",
            "fax_number": "859-368-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2387 PROFESSIONAL HEIGHTS DR STE 180",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033013",
            "telephone_number": "859-967-9486",
            "fax_number": "859-368-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LORI",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3002772",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "3002772",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1078503",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3002772",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11221661",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "1078503",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78000007",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE REGISTERED NURSE",
            "identifier": "3002772",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ecw",
            "affiliation": "N",
            "endpointDescription": "ecw medical records",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "electronic medical records",
            "address_1": "2387 Professional Heights Dr Ste 180",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405033013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "BROMAGEN",
            "middle_name": "A",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allison Wagner, BCBA
• Brittany Lee Wagner
• Charlotte Wagner
• Haley Elizabeth Wagner, MSN, APRN, FNP-C
• Lars M Wagner, MD
• Marsha Winkler Wagner I, OT
• Mary Wagner, OT
• Maxwell Joseph Wagner, MD
• Melissa Kay Wagner, LPCA
• Miriam Denise Wagner

• Adult Health Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Adult Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.