Active NPI
Shelley D Piasecki, M.D.
- Psychiatry Physician
- Fond Du Lac, WI
National Provider Identifier
1225051741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 43695-020
- Practice address
- 751 County Road K
Fond Du Lac, WI 54937-6007 - Phone
- (920) 929-6716
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 43695-020 | WI | Primary |
Addresses
Primary practice location
751 County Road K
Fond Du Lac, WI 54937-6007
Mailing address
610 Riverfront Drive
Sheboygan
Sheboygan, WI 53083-1679
Phone (920) 457-5703
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34522500 | Medicaid | WI | |
| 14823 | Other | NETWORK HEALTH PLAN |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43695-020 | WI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405900800000",
"number": "1225051741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 RIVERFRONT DRIVE",
"address_2": "SHEBOYGAN",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530831679",
"telephone_number": "920-457-5703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "751 COUNTY ROAD K",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549376007",
"telephone_number": "920-929-6716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIASECKI",
"first_name": "SHELLEY",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2014-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WI",
"license": "43695-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34522500",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH PLAN",
"identifier": "14823",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.