Individual provider Active NPI

Stacey L Zarnstorff Green, APN

  • Nurse Practitioner
  • Richmond, IL
National Provider Identifier
1245243369
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
041-265243 Issued in IL
Practice address
4719 Concord LN
Richmond, IL 60071-9010
Phone
(815) 669-4228
NPI assigned
Aug 14, 2006
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 041-265243 IL Primary

Addresses

Primary practice location

4719 Concord LN
Richmond, IL 60071-9010

Mailing address

4719 Concord LN
Richmond, IL 60071-9010
Phone (815) 669-4228

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address szarnstorffgreen42421@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070731000308 WI Practitioner - Nurse Practitioner 9234230509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2707 15TH PL
Kenosha, WI 53140-4947

3301 W Forest Home Ave
Milwaukee, WI 53215-2843

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3129WIMDClinical Psychologist
041-265243ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Aug 1, 2007 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 1, 2007 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

2707 15th Pl
Kenosha, WI 53140
Phone (262) 551-2700

7540 22nd Ave
Kenosha, WI 53143
Phone (262) 605-3674

7550 22nd Ave
Kenosha, WI 53143
Phone (262) 658-2500

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

Interoperability endpoints

  • Direct secure messaging: szarnstorffgreen42421@direct.myadvocateaurora.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1245243369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 CONCORD LN",
            "city": "RICHMOND",
            "state": "IL",
            "postal_code": "600719010",
            "telephone_number": "815-669-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4719 CONCORD LN",
            "city": "RICHMOND",
            "state": "IL",
            "postal_code": "600719010",
            "telephone_number": "815-669-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZARNSTORFF GREEN",
        "first_name": "STACEY",
        "middle_name": "L",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041-265243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "szarnstorffgreen42421@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4719 Concord Ln",
            "city": "Richmond",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600719010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4719 Concord Ln",
            "city": "Richmond",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600719010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond, IL

Sources for this page

Verify at the official NPI Registry.