Active NPI
Lori L Kisting, APNP
- Nurse Practitioner
- Stevens Point, WI
National Provider Identifier
1780932608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4917
- Practice address
- 824 Illinois Ave
Stevens Point, WI 54481-3112 - Phone
- (715) 342-7500
- NPI assigned
- Aug 27, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4917 | WI | Primary |
Addresses
Primary practice location
824 Illinois Ave
Stevens Point, WI 54481-3112
Mailing address
824 Illinois Ave
Stevens Point, WI 54481-3112
Phone (715) 342-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4917 | Other | WI | WI STATE LIC |
Other names 1
- Ms. Lori Lee Dedeker / Wiernik
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Dec 13, 2021 through Dec 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618272000000",
"number": "1780932608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "824 ILLINOIS AVE",
"city": "STEVENS POINT",
"state": "WI",
"postal_code": "544813112",
"telephone_number": "715-342-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "824 ILLINOIS AVE",
"city": "STEVENS POINT",
"state": "WI",
"postal_code": "544813112",
"telephone_number": "715-342-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISTING",
"first_name": "LORI",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-27",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "4917",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WI STATE LIC",
"identifier": "4917",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LORI",
"last_name": "DEDEKER / WIERNIK",
"middle_name": "LEE",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Stevens Point, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.