Active NPI
Vicki Lou Stork
- Medical-Surgical Registered Nurse
- Carroll, IA
National Provider Identifier
1336325802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- 079618
- Practice address
- 311 S Clark St
Carroll, IA 51401-3038 - Phone
- (712) 794-0826
- NPI assigned
- Jan 15, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 079618 | IA | Primary |
Addresses
Primary practice location
311 S Clark St
Carroll, IA 51401-3038
Mailing address
131 W 3Rd St.
Glidden, IA 51443
Phone (712) 830-2511
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 079618 | IA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200355200000",
"number": "1336325802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 W 3RD ST.",
"city": "GLIDDEN",
"state": "IA",
"postal_code": "51443",
"telephone_number": "712-830-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 S CLARK ST",
"city": "CARROLL",
"state": "IA",
"postal_code": "514013038",
"telephone_number": "712-794-0826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STORK",
"first_name": "VICKI",
"middle_name": "LOU",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-15",
"last_updated": "2008-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "IA",
"license": "079618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carroll, IA
- St. Anthony Regional Hospital and Nursing Home
- St. Anthony Regional Hospital and Nursing Home
- St. Anthony Regional Hospital and Nursing Home
- Christopher Bryan Staub, DPT, OCS, CGFI, MBA
- Monica Sue Steinborn, LAT
- Michelle Nicole Sturm, D.D.S.
- Sunnybrook of Carroll
- Lisa Marie Tank, LPN
- Marlys J Taylor, LISW
- Cathy C Tigges, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.