Individual provider Active NPI

Mary Stephanie Wright, APNP

  • Primary Care Nurse Practitioner
  • Kiel, WI
National Provider Identifier
1790057560
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4767-33 Issued in WI
Practice address
502 Highway 67
Kiel, WI 53042-1650
Phone
(920) 894-5661
Fax
(920) 894-1120
NPI assigned
Feb 8, 2012
Last updated
Sep 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4767-33 WI Primary
Nurse Practitioner 363L00000X 4767 WI

Addresses

Primary practice location

502 Highway 67
Kiel, WI 53042-1650

Mailing address

334 Emerald Hills Dr
Fredonia, WI 53021-9351
Phone (262) 483-4374

Other practice location 1

334 Emerald Hills Dr
Fredonia, WI 53021-9351
Phone (262) 483-4374

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
I20120502000686 WI Practitioner - Nurse Practitioner 7911169206 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4767WIMDNurse Practitioner
4767-33WIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jan 24, 2024 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Dec 25, 2023 Accepting new patients
Prevea Clinic, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Prevea Clinic, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

2502 S Ashland Ave
Green Bay, WI 54304
Phone (920) 496-4750

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

502 Highway 67
Kiel, WI 53042
Phone (920) 894-5661

825 Walton Dr
Plymouth, WI 53073
Phone (920) 889-0302

1020 S Taylor Dr
Sheboygan, WI 53081
Phone (920) 452-5437

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Interoperability endpoints

  • Direct secure messaging: mschad39078@ewd.direct.hshs.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, 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": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1790057560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 EMERALD HILLS DR",
            "city": "FREDONIA",
            "state": "WI",
            "postal_code": "530219351",
            "telephone_number": "262-483-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 HIGHWAY 67",
            "city": "KIEL",
            "state": "WI",
            "postal_code": "530421650",
            "telephone_number": "920-894-5661",
            "fax_number": "920-894-1120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "334 Emerald Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Fredonia",
            "state": "WI",
            "postal_code": "530219351",
            "country_code": "US",
            "telephone_number": "262-483-4374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "MARY",
        "middle_name": "STEPHANIE",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "4767-33",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4767",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kiel, WI

Sources for this page

Verify at the official NPI Registry.