Stephen M. Kordiyak, C.R.N.A.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

113499 Issued in WI

Practice address

115 E 5TH Ave
Antigo, WI 54409-2711

Phone

(715) 623-2331

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Bellin Anesthesia Associates, S.C.

  • Pain Medicine (Anesthesiology) Physician
  • Green Bay, WI
  • NPI 1558318410
  NPD (past)
• Millenium Anesthesiologists, LTD.

  • Anesthesiology Physician
  • Green Bay, WI
  • NPI 1215003082
  NPD (past)
• Nicklaus Counseling Center SC

  • Professional Counselor
  • Marinette, WI
  • NPI 1033659271
  NPD (past)
• Peace Counseling & Support Services LLC

  • Mental Health Counselor
  • Marinette, WI
  • NPI 1992633309
  NPD (past)
• St Clare Memorial Hospital, Inc.

  dba St Clare Memorial Hospital Pharmacy

  • Institutional Pharmacy
  • Oconto Falls, WI
  • NPI 1073536967
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270166400000",
    "number": "1912978099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S EXECUTIVE DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054257",
            "telephone_number": "262-787-4026",
            "fax_number": "262-782-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092711",
            "telephone_number": "715-623-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORDIYAK",
        "first_name": "STEPHEN",
        "middle_name": "M.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2010-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "113499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA RECERTIFICATION CARD",
            "identifier": "044383",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43314500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tessa Kitzman
• Richard A Kjome, O.D.
• Michelle A Klingler, OT
• Bartley R Kneeland, MD
• Jolene M Kopplin, NP
• Michael Benjamin Kowitz
• Lisa Michelle Krebs, D.D.S.
• Krueger Chiropractic LLC
• Andrew Cary Krueger, D.C.
• Hannah Elizabeth Krueger, MASSAGE THERAPIST

• Certified Registered Nurse Anesthetist in Antigo, WI
• Providers in Antigo, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2010; 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.