Individual provider Active NPI

Stacey J Hittman, APNP

  • Family Nurse Practitioner
  • De Pere, WI
National Provider Identifier
1487809943
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3643-33 Issued in WI
Practice address
1700 Sand Acres Dr Ste 2a
De Pere, WI 54115-7562
Phone
(920) 373-8086
NPI assigned
Nov 25, 2008
Last updated
Jun 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6235 MN
Family Nurse Practitioner 363LF0000X 3643-33 WI Primary

Addresses

Primary practice location

1700 Sand Acres Dr Ste 2a
De Pere, WI 54115-7562

Mailing address

1700 Sand Acres Dr Ste 2a
De Pere, WI 54115-7562
Phone (920) 819-2657

Other practice location 1

1600 Ely St
Bellin Employer Clinic Marinette Marine
Marinette, WI 54143
Phone (715) 732-1649

Other practice location 2

1326 Buckys Run
Green Bay, WI 54313-7500
Phone (920) 373-8086

Other names 1

  • Stacey M Hittman, Schmidt-Pristelski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6235MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1487809943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SAND ACRES DR STE 2A",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541157562",
            "telephone_number": "920-819-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SAND ACRES DR STE 2A",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541157562",
            "telephone_number": "920-373-8086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 ELY ST",
            "address_2": "BELLIN EMPLOYER CLINIC MARINETTE MARINE",
            "address_purpose": "LOCATION",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "54143",
            "country_code": "US",
            "telephone_number": "715-732-1649",
            "fax_number": "715-732-1649",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1326 Buckys Run",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543137500",
            "country_code": "US",
            "telephone_number": "920-373-8086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HITTMAN",
        "first_name": "STACEY",
        "middle_name": "J",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-25",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6235",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "3643-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "HITTMAN, SCHMIDT-PRISTELSKI",
            "middle_name": "M",
            "credential": "APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.