Active NPI
Stephen W Noltner, M.D.
- Anesthesiology Physician
- Pewaukee, WI
National Provider Identifier
1891797650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 33101
- Practice address
- N21W24805 Still River Dr
Pewaukee, WI 53072-8507 - Phone
- (715) 577-9160
- NPI assigned
- Aug 11, 2005
- Last updated
- Oct 23, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 33101 | WI | Primary |
Addresses
Primary practice location
N21W24805 Still River Dr
Pewaukee, WI 53072-8507
Mailing address
N21W24805 Still River Dr
Pewaukee, WI 53072-8507
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31820800 | Medicaid | WI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33101 | WI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eau Claire Anesthesiologists LTD | Past | Accepting new patients | |
| Eau Claire Anesthesiologists LTD | Past | Accepting new patients | |
| Mayo Clinic Health System-Northwest Wisconsin Region, Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Critical Care Medicine (Anesthesiology) Physician
- Eau Claire, WI
- NPI 1295734580
-
- Certified Registered Nurse Anesthetist
- Eau Claire, WI
- NPI 1346249422
-
dba Mayo Clinic Health System-Barron
- Critical Access Hospital
- Barron, WI
- NPI 1740239557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698019200000",
"number": "1891797650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N21W24805 STILL RIVER DR",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530728507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N21W24805 STILL RIVER DR",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530728507",
"telephone_number": "715-577-9160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLTNER",
"first_name": "STEPHEN",
"middle_name": "W",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-11",
"last_updated": "2023-10-23",
"certification_date": "2023-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "33101",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31820800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pewaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.