Stacy L Bramstedt, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209.011830 Issued in IL

Practice address

608 35TH Ave
Moline, IL 61265-6138

Phone

(309) 277-3500

Fax

(309) 277-3050

NPI assigned

Sep 11, 2014

Last updated

Nov 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Stacy L Liedtke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sbramstedt@ora2099.srs-direct.com

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.

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1790186559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 VALLEY VIEW DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656138",
            "telephone_number": "309-762-5560",
            "fax_number": "309-762-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 35TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656138",
            "telephone_number": "309-277-3500",
            "fax_number": "309-277-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAMSTEDT",
        "first_name": "STACY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.011830",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011830",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A107683",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "LIEDTKE",
            "middle_name": "L",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian K Bonish, M.D.
• Nokhram Boodhoo, O.D.
• Alan Drake Bowles Edwards, M.D.
• Braaten Health LLC (Moline Rem Center)
• Braaten Health, LLC (Midwest Therapy)
• Emiley Brand, DPT
• Bravard Chiropractic Inc
• Bravo Care of Moline Inc (Rosewood Care Center of Moline)
• Brian Buckrop
• Brian J Anseeuw M.D. S.C. (Quad CIty Neurolgy and Spine)

• Nurse Practitioner in Moline, IL
• Providers in Moline, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.