Individual provider Active NPI

Destree Maxine Stutzman

  • Community/Behavioral Health Agency
  • Hastings, NE
National Provider Identifier
1609675800
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
618 W 11TH St
Hastings, NE 68901-3903
Phone
(308) 258-1936
NPI assigned
Mar 10, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X
Adult Companion 372600000X
Personal Care Attendant 3747P1801X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

618 W 11TH St
Hastings, NE 68901-3903

Mailing address

302 S Bellevue Ave
Hastings, NE 68901-5812
Phone (308) 258-1936

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1609675800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 S BELLEVUE AVE",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689015812",
            "telephone_number": "308-258-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 W 11TH ST",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689013903",
            "telephone_number": "308-258-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTZMAN",
        "first_name": "DESTREE",
        "middle_name": "MAXINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.