Stacey Mulry, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

81863-20 Issued in WI

Practice address

7322 W Rawson Ave
Franklin, WI 53132-8117

Phone

(414) 433-9010

Fax

(414) 433-9007

NPI assigned

Apr 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stacey Forton Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: smulry129989@direct.chw.org

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.

• Children'S Medical Group

  • Pediatrics Physician
  • Glendale, WI
  • NPI 1134394471
  NPD (past)

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1437779527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 N PALMER ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123928",
            "telephone_number": "616-581-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7322 W RAWSON AVE",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531328117",
            "telephone_number": "414-433-9010",
            "fax_number": "414-433-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULRY",
        "first_name": "STACEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-20",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "81863-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437779527",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "FORTON",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Molly A Morrow, OT
• Timothy Morschauser, DDS
• Leah Plaisier Mortensen
• Sarah Milena Mousai, RN
• Sandy Lee Mueller, PSY.D.
• Lloyd Munson, OT
• Avery Murdzek, RD
• Laura Murray
• Olivia Murray
• Reman Mustafa

• Pediatrics Physician in Franklin, WI
• Providers in Franklin, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.