Active NPI
Stephen Slattery
- Family Medicine Physician
- Waupun, WI
National Provider Identifier
1801807938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 37585
- Practice address
- 1 W Lincoln St
Dci Health Services
Waupun, WI 53963-1949 - Phone
- (920) 324-5577
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 42086 | MN | |
| Family Medicine Physician | 207Q00000X | 37585 | WI | Primary |
Addresses
Primary practice location
1 W Lincoln St
Dci Health Services
Waupun, WI 53963-1949
Mailing address
1 West Lincoln Street
Dci Health Services
Waupun, WI 53963
Phone (920) 324-5577
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42086 | MN | MD | Family Medicine Physician |
| 37585 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agnesian Healthcare Inc | 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.
-
- Community/Retail Pharmacy
- Waupun, WI
- NPI 1366417917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195516800000",
"number": "1801807938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 WEST LINCOLN STREET",
"address_2": "DCI HEALTH SERVICES",
"city": "WAUPUN",
"state": "WI",
"postal_code": "53963",
"telephone_number": "920-324-5577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 W LINCOLN ST",
"address_2": "DCI HEALTH SERVICES",
"city": "WAUPUN",
"state": "WI",
"postal_code": "539631949",
"telephone_number": "920-324-5577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLATTERY",
"first_name": "STEPHEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2007-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "42086",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "37585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waupun, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.