Individual provider Active NPI

Stacy McNall, APNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1477199693
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9875-33 Issued in WI
Practice address
1433 N Water St Ste 400-232
Milwaukee, WI 53202-2557
Phone
(415) 735-5804
NPI assigned
Nov 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 139856 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9875-33 WI Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 139856 WI

Addresses

Primary practice location

1433 N Water St Ste 400-232
Milwaukee, WI 53202-2557

Mailing address

25 Kessel CT Ste 105
Madison, WI 53711-6227
Phone (608) 280-2700

Other practice location 1

25 Kessel Ct Ste 105
Madison, WI 53711-6227
Phone (608) 280-2700

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200515002079 WI Practitioner - Nurse Practitioner 2163853607 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
139856WIMDAddiction (Substance Use Disorder) Registered Nurse
9875-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Rock County Clerk CurrentSince May 10, 2022 Accepting new patients
Journey Mental Health Center, Inc. CurrentSince Mar 30, 2020 Accepting new patients

Locations

1717 Center Ave
Janesville, WI 53546
Phone (608) 757-5025

25 Kessel Ct
Ste 105
Madison, WI 53711
Phone (608) 280-2636

49 Kessel Ct
Madison, WI 53711
Phone (608) 280-2510

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": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1477199693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 KESSEL CT STE 105",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116227",
            "telephone_number": "608-280-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 N WATER ST STE 400-232",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022557",
            "telephone_number": "415-735-5804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Kessel Ct Ste 105",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537116227",
            "country_code": "US",
            "telephone_number": "608-280-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNALL",
        "first_name": "STACY",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "139856",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "9875-33",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WI",
            "license": "139856",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.