Stacey Erica Madson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6286-015 Issued in WI

Practice address

1111 W Valley Rd
Appleton, WI 54915-1485

Phone

(920) 733-1111

Fax

(920) 380-4056

NPI assigned

Aug 6, 2008

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

Other names 1

• Dr. Stacey Erica Madson Reuss Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Forest View Dental, S.C.

  • General Practice Dentistry
  • Appleton, WI
  • NPI 1790712180
  NPD (past)

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1881850105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W VALLEY RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151485",
            "telephone_number": "920-733-1111",
            "fax_number": "920-380-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W VALLEY RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151485",
            "telephone_number": "920-733-1111",
            "fax_number": "920-380-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADSON",
        "first_name": "STACEY",
        "middle_name": "ERICA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6286-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "REUSS",
            "middle_name": "ERICA MADSON",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tara M Maclean, APNP
• Corey Stephan Macrander, MD
• Stephanus J Macrander, M.D.
• Alyssa Mader, RN
• Katlyn Madson, SACIT
• Jackie Maechtle, SACIT
• Michael F Maguire, M.D.
• Kalyn Mahoney, CPNP-AC
• Melanie A Mailand, PT
• Kristina G. Main

• General Practice Dentistry in Appleton, WI
• Providers in Appleton, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.