Individual provider Active NPI

Jessica Stier, M.D.

  • Psychiatry Physician
  • Rockford, IL
National Provider Identifier
1447608492
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036150720 Issued in IL
Practice address
1643 N Alpine Rd Ste 104-528
Rockford, IL 61107-1462
Phone
(815) 324-0346
NPI assigned
Jun 1, 2016
Last updated
Jun 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125.068539 IL
Psychiatry Physician 2084P0800X 036150720 IL Primary

Addresses

Primary practice location

1643 N Alpine Rd Ste 104-528
Rockford, IL 61107-1462

Mailing address

1643 N Alpine Rd Ste 104-528
Rockford, IL 61107-1462
Phone (815) 324-0346

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 12, 2023 through Jan 12, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036150720ILMDPsychiatry Physician
125.068539ILMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1447608492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 N ALPINE RD STE 104-528",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071462",
            "telephone_number": "815-324-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1643 N ALPINE RD STE 104-528",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071462",
            "telephone_number": "815-324-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIER",
        "first_name": "JESSICA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125.068539",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036150720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.