Individual provider Active NPI

Rachel Mary Grace Stiver, LPN

  • Licensed Practical Nurse
  • Wausau, WI
National Provider Identifier
1912415340
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
306551 Issued in WI
Practice address
916 S 10TH St
Wausau, WI 54403-6502
Phone
(414) 312-2982
NPI assigned
Jan 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X 306551 WI Primary

Addresses

Primary practice location

916 S 10TH St
Wausau, WI 54403-6502

Mailing address

1615 Jackson St
Merrill, WI 54452-3210
Phone (414) 312-2982

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

LicenseStateTypeSpecialty
306551WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1912415340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 JACKSON ST",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544523210",
            "telephone_number": "414-312-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 S 10TH ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036502",
            "telephone_number": "414-312-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIVER",
        "first_name": "RACHEL",
        "middle_name": "MARY GRACE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "306551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; 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.