Active NPI
Kathleen F Stierwalt, CNP
- Family Nurse Practitioner
- Fremont, OH
National Provider Identifier
1386971976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- COA11002-NP
- Practice address
- 1479 N River Rd
Fremont, OH 43420-9760 - Phone
- (419) 355-9440
- Fax
- (419) 355-9443
- NPI assigned
- Nov 3, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | COA11002-NP | OH | Primary |
Addresses
Primary practice location
1479 N River Rd
Fremont, OH 43420-9760
Mailing address
PO Box 378
Sandusky, OH 44871-0378
Phone (419) 609-1112
Other practice location 1
715 S Taft Ave
Fremont, OH 43420-3237
Phone (419) 334-6679
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| COA11002-NP | Other | OH | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA11002-NP | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Toledo Pain Services, PLL | Current | Accepting new patients | |
| Toledo Pain Services, PLL | Current | Accepting new patients |
Locations
715 S Taft Ave
Fremont, OH 43420
Phone (419) 332-7321
846 S Coy Rd
Ste 100
Oregon, OH 43616
5151 Monroe St
Ste 104
Toledo, OH 43623
Organizations & group practices 2
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.
-
- Interventional Pain Medicine Physician
- Toledo, OH
- NPI 1356339857
-
- Certified Registered Nurse Anesthetist
- Oregon, OH
- NPI 1427703024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1386971976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 378",
"city": "SANDUSKY",
"state": "OH",
"postal_code": "448710378",
"telephone_number": "419-609-1112",
"fax_number": "419-609-1123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1479 N RIVER RD",
"city": "FREMONT",
"state": "OH",
"postal_code": "434209760",
"telephone_number": "419-355-9440",
"fax_number": "419-355-9443"
}
],
"practiceLocations": [
{
"address_1": "715 S Taft Ave",
"address_purpose": "LOCATION",
"city": "Fremont",
"state": "OH",
"postal_code": "434203237",
"country_code": "US",
"telephone_number": "419-334-6679",
"fax_number": "419-334-6690",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STIERWALT",
"first_name": "KATHLEEN",
"middle_name": "F",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-03",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "COA11002-NP",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "COA11002-NP",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fremont, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.