Stella Wiltz, OWNER

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

11226 Issued in LA

Practice address

402 Richard Street
Breaux Bridge, LA 70517-7051

Phone

(337) 278-1810

NPI assigned

May 14, 2007

Last updated

May 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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• Activities of Daily Living

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• Activities of Daily Living Services

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• Activities of Daily Living Services Inc

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• Activities of Daily Living Behavioral Health Services Inc

  • Community/Behavioral Health Agency
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  • NPI 1588204150
  NPD

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1083829766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RICHARD ST",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705176039",
            "telephone_number": "337-332-1810",
            "fax_number": "337-332-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 RICHARD STREET",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705177051",
            "telephone_number": "337-278-1810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Richard St",
            "address_purpose": "LOCATION",
            "city": "Breaux Bridge",
            "state": "LA",
            "postal_code": "705176039",
            "country_code": "US",
            "telephone_number": "337-332-1810",
            "fax_number": "337-332-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILTZ",
        "first_name": "STELLA",
        "credential": "OWNER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "LA",
            "license": "11226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84-368-5768",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1721999",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Personal Care Attendant in Breaux Bridge, LA
• Providers in Breaux Bridge, LA by specialty
• Personal Care Attendant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.