Individual provider Active NPI

Allison L Stallbohm, APNP

  • Nurse Practitioner
  • Appleton, WI
National Provider Identifier
1619223146
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
144714 Issued in WI
Practice address
1501 S Madison St
Appleton, WI 54915-1846
Phone
(920) 730-4414
NPI assigned
Aug 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 144714 WI Primary

Addresses

Primary practice location

1501 S Madison St
Appleton, WI 54915-1846

Mailing address

1501 S Madison St
Appleton, WI 54915-1846
Phone (920) 730-4414

Other names 1

  • Allison L Gebheim Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address allison.stallbohm.1@10114.direct.athenahealth.com

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
I20121002000772 WI Practitioner - Nurse Practitioner 4789833039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Main St
Neenah, WI 54956-2570
Phone (920) 727-4200

1420 Algoma St
New London, WI 54961-2104
Phone (920) 982-8300

1501 S Madison St
Appleton, WI 54915-1846
Phone (920) 738-2000

1506 S Oneida St
Appleton, WI 54915-1305
Phone (920) 738-2000

200 Patriot Dr
Little Chute, WI 54140-1184
Phone (920) 687-2800

2601 Fieldcrest Dr
Kaukauna, WI 54130-4523
Phone (920) 462-6100

3329 N Richard St
Appleton, WI 54911-1063
Phone (920) 380-2715

W6981 Parkview Dr
Greenville, WI 54942-8034
Phone (920) 882-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
144714WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Aug 20, 2012 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Aug 20, 2012 Accepting new patients

Locations

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1619223146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151846",
            "telephone_number": "920-730-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151846",
            "telephone_number": "920-730-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLBOHM",
        "first_name": "ALLISON",
        "middle_name": "L",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-02",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "144714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "allison.stallbohm.1@10114.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1501 S Madison St",
            "city": "Appleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549151846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "GEBHEIM",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.