Individual provider Active NPI

Stephanie Litsheim, DNP, CNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mankato, MN
National Provider Identifier
1952994782
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
7815 Issued in MN
Practice address
1400 Madison Ave Ste 352
Mankato, MN 56001-4458
Phone
(507) 387-3195
Fax
(507) 387-4785
NPI assigned
Feb 12, 2021
Last updated
Oct 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 7815 MN Primary

Addresses

Primary practice location

1400 Madison Ave Ste 352
Mankato, MN 56001-4458

Mailing address

1400 Madison Ave Ste 352
Mankato, MN 56001-4458
Phone (507) 387-3195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210426002781 MN Practitioner - Nurse Practitioner 7810305174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mankato Clinic LTDGroup PAC ID 5597677955, 243 clinicians

Practice addresses (Care Compare)

1230 E Main St
Mankato, MN 56001-5066
Phone (507) 389-8509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7815MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mankato Clinic LTD CurrentSince Sep 1, 2021 Accepting new patients

Locations

1230 E Main St
Mankato, MN 56001
Phone (507) 389-8502

1400 Madison Ave
Ste 352
Mankato, MN 56001
Phone (507) 387-3195

Interoperability endpoints

  • Direct secure messaging: stephanielitsheim@mklt.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1952994782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE STE 352",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014458",
            "telephone_number": "507-387-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE STE 352",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014458",
            "telephone_number": "507-387-3195",
            "fax_number": "507-387-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITSHEIM",
        "first_name": "STEPHANIE",
        "credential": "DNP, CNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "7815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.