Individual provider Active NPI

Elaine Marie Stallbaum, BA

  • Peer Specialist
  • Norfolk, NE
National Provider Identifier
1295158830
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
CPSS422 Issued in NE
Practice address
1203 S 8TH St
Norfolk, NE 68701-5875
Phone
(402) 371-0220
Fax
(402) 644-4593
NPI assigned
Feb 3, 2014
Last updated
May 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU
Peer Specialist 175T00000X CPSS422 NE Primary

Addresses

Primary practice location

1203 S 8TH St
Norfolk, NE 68701-5875

Mailing address

PO Box 1392
Norfolk, NE 68702-1392
Phone (402) 371-0220

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
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
CPSS422NEMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1295158830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1392",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687021392",
            "telephone_number": "402-371-0220",
            "fax_number": "402-644-4593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 S 8TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015875",
            "telephone_number": "402-371-0220",
            "fax_number": "402-644-4593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLBAUM",
        "first_name": "ELAINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-03",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NE",
            "license": "CPSS422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.