Brenda K Stickley

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

2695463 Issued in OH

Practice address

610 E Chestnut St
Wauseon, OH 43567-1463

Phone

(419) 357-9292

NPI assigned

Nov 22, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1114520046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 E CHESTNUT ST",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671463",
            "telephone_number": "419-357-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E CHESTNUT ST",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671463",
            "telephone_number": "419-357-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKLEY",
        "first_name": "BRENDA",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-22",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "OH",
            "license": "2695463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0180383",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2695463",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bstickley@wauseonindians.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "wauseon",
            "address_1": "610 E Chestnut St",
            "city": "Wauseon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435671463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Sostakowski, PHARMD
• Christopher Joseph Spieles, M.D.
• Bonnie Spiess
• Jamie Spiess
• John Stehulak, O.D.
• Emily Stockham
• Crissi L Stuckey, PT
• Alicia Sumner
• Sunshine Inc. Residential and Support Services
• Molly Nicole Suter, M.S. CF-SLP

• Preferred Provider Organization in Wauseon, OH
• Providers in Wauseon, OH by specialty
• Preferred Provider Organization in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2020; 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.