Individual provider Active NPI

Kathleen F Stierwalt, CNP

  • Family Nurse Practitioner
  • Fremont, OH
National Provider Identifier
1386971976
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA11002-NP Issued in OH
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

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
COA11002-NPOtherOHSTATE 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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA11002-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Pain Services, PLL CurrentSince Aug 1, 2014 Accepting new patients
Toledo Pain Services, PLL CurrentSince Aug 1, 2014 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.

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

Verify at the official NPI Registry.