Individual provider Active NPI

Debra S Schmidt-Stucke, RN

  • Registered Nurse
  • Campbellsport, WI
National Provider Identifier
1932469665
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
105479-030 Issued in WI
Practice address
N2209 Cty Rd K
Campbellsport, WI 53030-1538
Phone
(920) 979-0002
NPI assigned
May 29, 2012
Last updated
May 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 105479-030 WI Primary

Addresses

Primary practice location

N2209 Cty Rd K
Campbellsport, WI 53030-1538

Mailing address

N2209 County Road K
Campbellsport, WI 53010-1538
Phone (920) 979-0003

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
105479-030WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1932469665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N2209 COUNTY ROAD K",
            "city": "CAMPBELLSPORT",
            "state": "WI",
            "postal_code": "530101538",
            "telephone_number": "920-979-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N2209 CTY RD K",
            "city": "CAMPBELLSPORT",
            "state": "WI",
            "postal_code": "530301538",
            "telephone_number": "920-979-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT-STUCKE",
        "first_name": "DEBRA",
        "middle_name": "S",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "105479-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsport, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; 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.