Active NPI
Stacy Steele
- Case Manager/Care Coordinator
- Jamestown, ND
National Provider Identifier
1659962546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 420 20TH St SW
Jamestown, ND 58401-6227 - Phone
- (701) 223-2417
- NPI assigned
- Feb 2, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | |||
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
420 20TH St SW
Jamestown, ND 58401-6227
Mailing address
4909 Shelburne St
Bismarck, ND 58503-5605
Other practice location 1
425 College Dr S Ste 8
Devils Lake, ND 58301-3537
Phone (701) 223-2417
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1481496 | Medicaid | ND | |
| 1481759 | Medicaid | ND |
Other names 1
- Stacy Widmer
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Options for Residential and Employment Services, Inc | Case Manager/Care Coordinator | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Case Manager/Care Coordinator
- Bismarck, ND
- NPI 1356951503
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618444800000",
"number": "1659962546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4909 SHELBURNE ST",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585035605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 20TH ST SW",
"city": "JAMESTOWN",
"state": "ND",
"postal_code": "584016227",
"telephone_number": "701-223-2417"
}
],
"practiceLocations": [
{
"address_1": "425 College Dr S Ste 8",
"address_purpose": "LOCATION",
"city": "Devils Lake",
"state": "ND",
"postal_code": "583013537",
"country_code": "US",
"telephone_number": "701-223-2417",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEELE",
"first_name": "STACY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-02",
"last_updated": "2021-04-15",
"certification_date": "2021-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1481496",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1481759",
"state": "ND"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "STACY",
"last_name": "WIDMER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Jamestown, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.