Individual provider Active NPI

Laura Stafford, APNP

  • Acute Care Nurse Practitioner
  • Neenah, WI
National Provider Identifier
1245848423
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
10188-33 Issued in WI
Practice address
300 N Commercial St
Neenah, WI 54956-2619
Phone
(920) 886-0818
NPI assigned
Jul 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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 10188-33 WI
Acute Care Nurse Practitioner 363LA2100X 10188-33 WI Primary

Addresses

Primary practice location

300 N Commercial St
Neenah, WI 54956-2619

Mailing address

300 N Commercial St
Neenah, WI 54956-2619
Phone (920) 886-0818

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
I20200819003757 WI Practitioner - Nurse Practitioner 4284050360 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

15010 W Greenfield Ave
Suite 102
Brookfield, WI 53005-7068
Phone (877) 448-3627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10188-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Nephrology Partners S C CurrentSince Jul 13, 2020 Accepting new patients
Thedacare Medical Center - Shawano, Inc. Past Accepting new patients

Locations

300 N Commercial St
Neenah, WI 54956
Phone (920) 725-7861

300 N Commercial St
#200
Neenah, WI 54956
Phone (920) 886-0818

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1245848423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562619",
            "telephone_number": "920-886-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562619",
            "telephone_number": "920-886-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10188-33",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WI",
            "license": "10188-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.