Individual provider Active NPI

Stacey Lea Spahn, APNP, FNP-C

  • Family Nurse Practitioner
  • Wisconsin Rapids, WI
National Provider Identifier
1639326143
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14197-33 Issued in WI
Practice address
460 N Biron Dr
Wisconsin Rapids, WI 54494-1843
Phone
(715) 507-6118
Fax
(833) 471-4700
NPI assigned
Aug 27, 2008
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 852688 NV
Family Nurse Practitioner 363LF0000X 14197-33 WI Primary
Registered Nurse 163W00000X 128550-030 WI

Addresses

Primary practice location

460 N Biron Dr
Wisconsin Rapids, WI 54494-1843

Mailing address

7795 Lake Thomas Rd
Stevens Point, WI 54482-9744
Phone (715) 347-5654

Other identifiers 1

IdentifierTypeStateIssuer
35061700MedicaidWI

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
128550-030WIMDRegistered Nurse
14197-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MH Health Care Services, PC CurrentSince Apr 27, 2025 Accepting new patients

Locations

460 N Biron Dr
Wisconsin Rapids, WI 54494
Phone (715) 507-6118

Interoperability endpoints

  • Direct secure messaging: stacey.spahn.1@14940.direct.athenahealth.com

Organizations & group practices 1

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": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1639326143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7795 LAKE THOMAS RD",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544829744",
            "telephone_number": "715-347-5654",
            "fax_number": "833-471-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N BIRON DR",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544941843",
            "telephone_number": "715-507-6118",
            "fax_number": "833-471-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAHN",
        "first_name": "STACEY",
        "middle_name": "LEA",
        "name_prefix": "Ms.",
        "credential": "APNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "852688",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "14197-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "128550-030",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35061700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.