Active NPI
Julie K Stade, PA-C
- Physician Assistant
- Haven, KS
National Provider Identifier
1992998223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 15-00954
- Practice address
- 12416 S Haven Rd
Haven, KS 67543-8228 - Phone
- (620) 465-3657
- NPI assigned
- Aug 21, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 15-00954 | KS | Primary |
Addresses
Primary practice location
12416 S Haven Rd
Haven, KS 67543-8228
Mailing address
12416 S Haven Rd
Haven, KS 67543-8228
Phone (620) 465-3657
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0425243 | KS | MD | Hematology & Oncology Physician |
| 15-00954 | KS | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207267200000",
"number": "1992998223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12416 S HAVEN RD",
"city": "HAVEN",
"state": "KS",
"postal_code": "675438228",
"telephone_number": "620-465-3657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12416 S HAVEN RD",
"city": "HAVEN",
"state": "KS",
"postal_code": "675438228",
"telephone_number": "620-465-3657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STADE",
"first_name": "JULIE",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-21",
"last_updated": "2008-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KS",
"license": "15-00954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haven, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.