NPIMap

Organization Active NPI

Energize Health and Wellness

  • Family Medicine Physician
  • De Pere, WI
National Provider Identifier
1346892957
Registry record updated Aug 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ENERGIZE HEALTH AND WELLNESS
Practice address
1700 Sand Acres Dr Ste 2a
De Pere, WI 54115-7562
Phone
(920) 819-2657
NPI assigned
Jul 13, 2019
Last updated
Aug 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2019

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

Authorized official

Name
Stacey Hittman, FNP-BCNPI 1487809943
Title
Owner
Phone
(920) 373-8086

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1700 Sand Acres Dr Ste 2a
De Pere, WI 54115-7562

Mailing address

1716 Lawrence Dr
De Pere, WI 54115-9108

National Provider Directory

National Provider Directory

Locations

1716 Lawrence Dr
De Pere, WI 54115
Phone (920) 605-3115

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1562976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564790400000",
    "number": "1346892957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 LAWRENCE DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SAND ACRES DR STE 2A",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541157562",
            "telephone_number": "920-819-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENERGIZE HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-13",
        "last_updated": "2019-08-03",
        "status": "A",
        "authorized_official_last_name": "HITTMAN",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-373-8086",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2019; 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.