Individual provider Active NPI

Wendy J. Stager, RN

  • Registered Nurse
  • Greendale, WI
National Provider Identifier
1194999862
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
66398-030 Issued in WI
Practice address
6694 Hill Ridge Dr
Greendale, WI 53129-2720
Phone
(414) 425-3528
Fax
(414) 425-3528
NPI assigned
Apr 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 66398-030 WI Primary

Addresses

Primary practice location

6694 Hill Ridge Dr
Greendale, WI 53129-2720

Mailing address

6694 Hill Ridge Dr
Greendale, WI 53129-2720
Phone (414) 425-3528

Other identifiers 1

IdentifierTypeStateIssuer
39919000MedicaidWI

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
66398-030WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1194999862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6694 HILL RIDGE DR",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292720",
            "telephone_number": "414-425-3528",
            "fax_number": "414-425-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6694 HILL RIDGE DR",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292720",
            "telephone_number": "414-425-3528",
            "fax_number": "414-425-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGER",
        "first_name": "WENDY",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "66398-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39919000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.