Active NPI
Kimberly Ann Stevens, APNP
- Family Nurse Practitioner
- Menasha, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 15343-33
- Practice address
- 1186 Appleton Rd
Menasha, WI 54952-1906 - Phone
- (920) 727-8700
- Fax
- (920) 727-8740
- NPI assigned
- May 10, 2024
- 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 | 15343-33 | WI | Primary |
Addresses
Primary practice location
1186 Appleton Rd
Menasha, WI 54952-1906
Mailing address
519 Riverway
Menasha, WI 54952-3430
Phone (850) 565-0060
Other practice location 1
2502 S Ashland Ave
Green Bay, WI 54304-5252
Phone (920) 496-4700
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kstevens456036@ewd.direct.hshs.org | Direct | St Vincent Hospital-Hospital Sisters-Third Order of St Francis |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240909000296 | WI | Practitioner - Nurse Practitioner | 9133669963 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15343-33 | WI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prevea Clinic, Inc. | Current | Accepting new patients | |
| Prevea Clinic, Inc. | Current | Accepting new patients |
Locations
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
2502 S Ashland Ave
Green Bay, WI 54304
Phone (920) 496-4750
1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016
3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710
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.
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- Green Bay, WI
- NPI 1306869276
-
- Family Medicine Physician
- Chippewa Falls, WI
- NPI 1588110969
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737072000000",
"number": "1467200758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "519 RIVERWAY",
"city": "MENASHA",
"state": "WI",
"postal_code": "549523430",
"telephone_number": "850-565-0060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1186 APPLETON RD",
"city": "MENASHA",
"state": "WI",
"postal_code": "549521906",
"telephone_number": "920-727-8700",
"fax_number": "920-727-8740"
}
],
"practiceLocations": [
{
"address_1": "2502 S Ashland Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543045252",
"country_code": "US",
"telephone_number": "920-496-4700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEVENS",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-10",
"last_updated": "2025-01-17",
"certification_date": "2025-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "15343-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kstevens456036@ewd.direct.hshs.org",
"affiliation": "Y",
"affiliationName": "St Vincent Hospital-Hospital Sisters-Third Order of St Francis",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "2502 S Ashland Ave",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543045252",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Menasha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.