MRS. STACY A LEIDEL (NPI# 1154415842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154415842 |
| Entity Type | Individual |
| Full Name | MRS. STACY A LEIDEL |
| Credential | APNP |
| Practice Address |
1102 S Park St Madison WI 53715-1708 |
| Mailing Address |
2901 W Beltline Hwy Suite 120 Madison WI 53713-4226 |
| Practice Telephone | 6082633111 |
| Practice Fax Number | 6082636663 |
| Mailing Telephone | 6084435500 |
| Mailing Fax Number | 6084412385 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-02-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 226405-30 | WI | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 6809-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1154415842 | 05 | |
| CAQH | 11934107 | 01 |
| Street Address |
1102 S PARK ST |
| City | MADISON |
| State | WI |
| Zip Code | 53715-1708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609878453 | Cheryl Roets | Psychologist | 1102 S Park St, Madison, WI 53715-1708 | 2005-08-11 |
| 1679102537 | Caroline Hensley | Student in an Organized Health Care Education/Training Program | 1102 S Park St, Madison, WI 53715-1708 | 2020-04-03 |
| 1720617624 | Justin Temple | Student in an Organized Health Care Education/Training Program | 1102 S Park St, Madison, WI 53715-1708 | 2020-04-03 |
| 1770112658 | Ana Pearson | Student in an Organized Health Care Education/Training Program | 1102 S Park St, Madison, WI 53715-1708 | 2020-04-03 |
| 1669001616 | Estefan Beltran | Student in an Organized Health Care Education/Training Program | 1102 S Park St, Madison, WI 53715-1708 | 2020-04-02 |
| 1003378886 | Melanie A Hellrood | Student in an Organized Health Care Education/Training Program | 1102 S Park St, Madison, WI 53715-1708 | 2019-04-02 |
| 1831651603 | Anne M Drolet | Student in an Organized Health Care Education/Training Program | 1102 S Park St, Madison, WI 53715-1708 | 2019-04-02 |
| 1568924363 | Morgan S White | Student in an Organized Health Care Education/Training Program | 1102 S Park St, Madison, WI 53715-1708 | 2019-04-02 |
| 1619439403 | Jeremiah J Shaw | Student in an Organized Health Care Education/Training Program | 1102 S Park St, Madison, WI 53715-1708 | 2019-04-02 |
| 1912486531 | Rachael Marie Finn | Physician Assistant | 1102 S Park St, Madison, WI 53715 | 2018-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851807697 | Kristi M Batchelor | Nurse Practitioner | 20 S Park St Fl 4, Madison, WI 53715 | 2017-12-15 |
| 1578927026 | Petra A Kelsey | Family Medicine | 1107 Emerald St, Madison, WI 53715 | 2016-04-11 |
| 1467889238 | Group Health Cooperative of South Central Wi | Durable Medical Equipment & Medical Supplies | 740 Regent Street, Suite 106, Madison, WI 53715 | 2013-10-10 |
| 1275888760 | Sandra Beth Miller | Physician Assistant | 700 S. Park, Suite A 404, Madison, WI 53715 | 2012-07-20 |
| 1134418486 | Matthew Lochen | Emergency Medicine | 700 S. Park Street, Department of Emergency Medicine, Madison, WI 53715 | 2011-04-06 |
| 1225275720 | Eileen J Breitweiser | Social Worker | 202 South Parkt Street, Madison, WI 53715 | 2009-01-21 |
| 1225293137 | Kenneth H. Yuska, Md, Sc | Orthopaedic Surgery | 4726 East Towne Blvd., 110, Madison, WI 53715 | 2008-07-21 |
| 1063689727 | Rachel I Kornik | Dermatology | Uw Health Dept of Dermatology 1 S. Park St, Administrative Office 7th Floor, Madison, WI 53715 | 2008-05-13 |
| 1144434911 | Rebecca Sue Frye | Pharmacist | 1 South Park Street, Suite 101 Pharmacy, Madison, WI 53715 | 2007-05-10 |
| 1376755496 | Eileen C. Scrivner | Social Worker | 1008 Fish Hatchery Road, Madison, WI 53715 | 2007-05-03 |
| Find all providers in zip 53715 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235740556 | Lucille Elizabeth Nathwani | Nurse Practitioner | Uw Medical Foundation 600 Highland Ave, Madison, WI 53792-0001 | 2020-08-11 |
| 1770193419 | Madison Emergency Group, PC | Nurse Practitioner | 1740 Lions Club Rd, Madison, GA 30650-4762 | 2020-08-07 |
| 1376169920 | Brittany Linton | Nurse Practitioner | 149 Fountains Blvd, Madison, MS 39110-6344 | 2020-06-19 |
| 1811517402 | Lillian Teicher Branham | Nurse Practitioner | 382 Slaughter Rd, Madison, AL 35758-2008 | 2020-04-23 |
| 1275179509 | Claire E P Bergman | Nurse Practitioner | 20 S Park St Ste 360, Madison, WI 53715-1387 | 2019-11-21 |
| 1750923538 | Samuel Scott Mccullough IIi | Nurse Practitioner | 120 Fountains Blvd # 1000, Madison, MS 39110-6343 | 2019-10-12 |
| 1083266779 | Heather Hontzas | Nurse Practitioner | 159 Fountains Blvd Ste A, Madison, MS 39110-6344 | 2019-07-12 |
| 1114404118 | Allison Dyrek | Nurse Practitioner | 20 S Park St Ste 405, Madison, WI 53715-1378 | 2018-07-23 |
| 1851807697 | Kristi M Batchelor | Nurse Practitioner | 20 S Park St Fl 4, Madison, WI 53715 | 2017-12-15 |
| 1366962045 | Katherine Marie Domes | Nurse Practitioner | 5804 Halley Way, Madison, WI 53718-2934 | 2017-06-22 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.