Active NPI
Susan M Stickney, CRNA
- Certified Registered Nurse Anesthetist
- Oshkosh, WI
National Provider Identifier
1619085453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 114752-030
- Practice address
- 855 N Westhaven Dr
Oshkosh, WI 54904-7668 - Phone
- (920) 303-8700
- Fax
- (920) 303-8789
- NPI assigned
- Aug 29, 2006
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 114752-030 | WI | Primary |
Addresses
Primary practice location
855 N Westhaven Dr
Oshkosh, WI 54904-7668
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4332200 | Medicaid | WI |
Other names 1
- Susan M Zink
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sstickney43709@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110222001074 | WI | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 8921289000 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114752-030 | WI | MD | Certified Registered Nurse Anesthetist |
Interoperability endpoints
- sstickney43709@direct.myadvocateaurora.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1619085453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 N WESTHAVEN DR",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549047668",
"telephone_number": "920-303-8700",
"fax_number": "920-303-8789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STICKNEY",
"first_name": "SUSAN",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WI",
"license": "114752-030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4332200",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sstickney43709@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "855 N Westhaven Dr",
"city": "Oshkosh",
"state": "WI",
"country_code": "US",
"postal_code": "549047668",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "855 N Westhaven Dr",
"city": "Oshkosh",
"state": "WI",
"country_code": "US",
"postal_code": "549047668",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "ZINK",
"middle_name": "M",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Oshkosh, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.