NPIMap

Individual provider Active NPI

Stacy Leigh Mohr, M.D.

  • Family Medicine Physician
  • Kaukauna, WI
National Provider Identifier
1770877664
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
62695-20 Issued in WI
Practice address
305 E 12TH St
Kaukauna, WI 54130-2865
Phone
(920) 766-4656
Fax
(920) 766-4659
NPI assigned
Jun 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 62695-20 WI Primary

Addresses

Primary practice location

305 E 12TH St
Kaukauna, WI 54130-2865

Mailing address

305 E 12TH St
Kaukauna, WI 54130-2865
Phone (920) 766-7656

Other names 1

  • Dr. Stacy Leigh Quella Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140815001297 WI Practitioner - Family Practice 7719137793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaukauna Clinic, S.C.Group PAC ID 5597765891, 8 clinicians

Practice addresses (Care Compare)

305 E 12TH St
Kaukauna, WI 54130-2865
Phone (920) 766-4656

Hospital & facility affiliations

  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
62695-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Family Medicine CurrentSince Aug 7, 2014 Accepting new patients
Bellin Memorial Hospital Inc Family Medicine Current Accepting new patients
Bellin Memorial Hospital Inc Family Medicine CurrentSince Aug 7, 2014 Accepting new patients
Kaukauna Clinic, S.C. Family Medicine CurrentSince Dec 1, 2025 Accepting new patients
Bellin Memorial Hospital Inc Family Medicine Past Accepting new patients

Locations

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

744 S Webster Ave
Fl 7
Green Bay, WI 54301

1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700

305 E 12th St
Kaukauna, WI 54130
Phone (920) 731-3111

Interoperability endpoints

  • Direct secure messaging: squella140928@direct.thedacare.org

Organizations & group practices 5

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 12

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": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1770877664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E 12TH ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541302865",
            "telephone_number": "920-766-7656",
            "fax_number": "920-766-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E 12TH ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541302865",
            "telephone_number": "920-766-4656",
            "fax_number": "920-766-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHR",
        "first_name": "STACY",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "62695-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "QUELLA",
            "middle_name": "LEIGH",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kaukauna, WI

Sources for this page

Verify at the official NPI Registry.