Mary Stample, APNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

13509-33 Issued in WI

Practice address

2500 E Enterprise Ave Ste B
Appleton, WI 54913-8556

Phone

(920) 416-8577

NPI assigned

Jan 19, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Farrar and Associates Mental Health SCGroup PAC ID 4981031309, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Farrar and Associates Mental Health SC

  • Psychiatry Physician
  • Appleton, WI
  • NPI 1649802281
  Medicare reassignment Care Compare group NPD
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment NPD
• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1750096145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E ENTERPRISE AVE STE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138556",
            "telephone_number": "920-416-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E ENTERPRISE AVE STE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138556",
            "telephone_number": "920-416-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMPLE",
        "first_name": "MARY",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "13509-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy H Stack
• Richard A Staehler, MD
• Mark A Stahl, MSE, CADC, LPC
• Stairgoddess, LLC
• Allison L Stallbohm, APNP
• Roger Gary Stanek, D.D.S.
• Eric Jon Stanelle, M.D.
• Ryan Stanke, PHARMD
• Star Bright Therapy LLC
• Mary Jo Stastny, MD

• Psychiatric/Mental Health Nurse Practitioner in Appleton, WI
• Providers in Appleton, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.