NPIMap

Individual provider Active NPI

Stephanie L Alban, NP

  • Nurse Practitioner
  • Seymour, WI
National Provider Identifier
1174126205
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10300-33 Issued in WI
Practice address
958 Foote St
Seymour, WI 54165-1044
Phone
(920) 833-9896
NPI assigned
Nov 20, 2020
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10300-33 WI Primary
Family Medicine Physician 207Q00000X 10300-33 WI

Addresses

Primary practice location

958 Foote St
Seymour, WI 54165-1044

Mailing address

958 Foote St
Seymour, WI 54165-1044

Other identifiers 1

IdentifierTypeStateIssuer
100141692MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address salban302358@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210120001586 WI Practitioner - Nurse Practitioner 0345654042 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

958 Foote St
Seymour, WI 54165-1044
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Dec 1, 2020 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Family Medicine Current Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Family Medicine CurrentSince Dec 1, 2020 Accepting new patients
Prevea Clinic, Inc. Family Medicine CurrentSince Dec 1, 2020 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Dec 1, 2020 Accepting new patients
Prevea Clinic, Inc. Family Medicine CurrentSince Dec 1, 2020 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Dec 1, 2020 Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

958 Foote St
Seymour, WI 54165
Phone (920) 833-7796

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Interoperability endpoints

  • Direct secure messaging: salban302358@ewd.direct.hshs.org

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1174126205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 FOOTE ST",
            "city": "SEYMOUR",
            "state": "WI",
            "postal_code": "541651044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 FOOTE ST",
            "city": "SEYMOUR",
            "state": "WI",
            "postal_code": "541651044",
            "telephone_number": "920-833-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBAN",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10300-33",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "10300-33",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100141692",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "salban302358@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "958 Foote St",
            "city": "Seymour",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541651044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seymour, WI

Sources for this page

Verify at the official NPI Registry.