Stacy Marie Vanegeren, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1471-19 Issued in WI

Practice address

2961 Saint Anthony Dr
Green Bay, WI 54311-5860

Phone

(920) 468-0861

Fax

(920) 468-5869

NPI assigned

Jan 12, 2012

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

• Miss Stacy Marie Toonen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1497025043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 SAINT ANTHONY DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115860",
            "telephone_number": "920-468-0861",
            "fax_number": "920-468-5869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961 SAINT ANTHONY DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115860",
            "telephone_number": "920-468-0861",
            "fax_number": "920-468-5869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANEGEREN",
        "first_name": "STACY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1471-19",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497025043",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "TOONEN",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebekah R Vandewalle, APNP
• Kimberly Anne Vandeyacht, PHARMD
• Ashley Vandyck, LPC-IT
• Christopher R Vandyke, M.S., BCBA
• Elizabeth Vanegeren
• Nenglee Vang, MSC
• Steven N Vang, D.O.
• Teegan Jay Vangheem, DPT
• Ashley Lynn Vanhandel, MS, BCBA, LBA
• Trisha Vankilsdonk, PT

• Physical Therapy Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; 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.