Individual provider Active NPI

Stacey Lynn Stephens, AGNP-C

  • Adult Health Nurse Practitioner
  • Marshfield, WI
National Provider Identifier
1316839046
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
17067-33 Issued in WI
Practice address
209 S Central Ave Ste 300
Marshfield, WI 54449-2836
Phone
(614) 439-0203
NPI assigned
Jul 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 17067-33 WI Primary

Addresses

Primary practice location

209 S Central Ave Ste 300
Marshfield, WI 54449-2836

Mailing address

225 W Washington St Ste 1500
Chicago, IL 60606-3485
Phone (855) 493-5523

Other names 1

  • Stacey Lynn Anderson Former name

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
I20250820001650 WI Order and Referring Only - Nurse Practitioner 7911406467

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17067-33WIMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1316839046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W WASHINGTON ST STE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063485",
            "telephone_number": "855-493-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S CENTRAL AVE STE 300",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544492836",
            "telephone_number": "614-439-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "17067-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "ANDERSON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marshfield, WI

Sources for this page

Verify at the official NPI Registry.