Individual provider Active NPI

Stefanie Lyn Kasun-Lamb, R.D.

  • Registered Dietitian
  • Brookfield, WI
National Provider Identifier
1265879183
Registry record updated Jun 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2262-29 Issued in WI
Practice address
3365 Fiebrantz Dr
Brookfield, WI 53005-3364
Phone
(715) 572-7863
NPI assigned
Jun 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2262-29 WI Primary

Addresses

Primary practice location

3365 Fiebrantz Dr
Brookfield, WI 53005-3364

Mailing address

3365 Fiebrantz Dr
Brookfield, WI 53005-3364
Phone (715) 572-7863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221119000183 WI Practitioner - Registered Dietitian Or Nutrition Professional 8921476144 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2262-29WIMDRegistered Dietitian
2262WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Nov 1, 2022 Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

19333 W North Ave
Brookfield, WI 53045
Phone (262) 785-2000

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 1

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": "1370044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370044800000",
    "number": "1265879183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3365 FIEBRANTZ DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053364",
            "telephone_number": "715-572-7863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 FIEBRANTZ DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053364",
            "telephone_number": "715-572-7863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASUN-LAMB",
        "first_name": "STEFANIE",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-01",
        "last_updated": "2013-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "2262-29",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.