Individual provider Active NPI

Lola A Wobken, RNC, WHNP

  • Women's Health Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1952449936
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
124610 Issued in MO
Practice address
1123 Wilkes Blvd Ste 100
Columbia, MO 65201-4774
Phone
(573) 514-7312
Fax
(573) 875-8687
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 124610 MO Primary

Addresses

Primary practice location

1123 Wilkes Blvd Ste 100
Columbia, MO 65201-4774

Mailing address

1123 Wilkes Blvd Ste 100
Columbia, MO 65201-4774
Phone (573) 514-7312

Other practice location 1

850 N Hospital Dr
Ste F
Fulton, MO 65251-2535
Phone (573) 642-5338

Other identifiers 1

IdentifierTypeStateIssuer
428150007MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124610MOMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Moberly Medical Clinics Inc Past Accepting new patients
Moberly Medical Clinics Inc Past Accepting new patients
Rain-Central Missouri, Inc. Past Accepting new patients
Suzanne E. Alt, D.O., LLC Past Accepting new patients
Midwest Heart and Vein Center, LLC Past Accepting new patients

Organizations & group practices 5

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952449936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 WILKES BLVD STE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652014774",
            "telephone_number": "573-514-7312",
            "fax_number": "573-875-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 WILKES BLVD STE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652014774",
            "telephone_number": "573-514-7312",
            "fax_number": "573-875-8687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 N Hospital Dr",
            "address_2": "Ste F",
            "address_purpose": "LOCATION",
            "city": "Fulton",
            "state": "MO",
            "postal_code": "652512535",
            "country_code": "US",
            "telephone_number": "573-642-5338",
            "fax_number": "573-642-9224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOBKEN",
        "first_name": "LOLA",
        "middle_name": "A",
        "credential": "RNC, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "124610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428150007",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.