STACIA LANGAN SACKMASTER (NPI# 1912330895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912330895 |
| Entity Type | Individual |
| Full Name | STACIA LANGAN SACKMASTER |
| Credential | APN |
| Practice Address |
401 Roxbury Rd Rockford IL 61107-5075 |
| Practice Telephone | 8153977340 |
| Practice Fax Number | 8153977388 |
| Mailing Telephone | 8153977340 |
| Mailing Fax Number | 8153977388 |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2013-08-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209010644 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
401 ROXBURY RD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-5075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205821089 | Brad Alan Bowyer | Internal Medicine | 401 Roxbury Rd, Rockford, IL 61107-5075 | 2005-09-16 |
| 1487197356 | Marjorie Hotopp | Nurse Practitioner | 401 Roxbury Rd, Rockford, IL 61107-5075 | 2016-11-28 |
| 1689000424 | Corrie Elizabeth Scott | Nurse Practitioner | 401 Roxbury Rd, Rockford, IL 61107-5075 | 2013-09-25 |
| 1538406053 | Jennifer A Ward | Nurse Practitioner | 401 Roxbury Rd, Rockford, IL 61107-5075 | 2013-01-04 |
| 1730426230 | Janelle D Defilippis | Nurse Practitioner | 401 Roxbury Rd, Rockford, IL 61107-5075 | 2013-01-04 |
| 1417209768 | Brenda L Garrett | Nurse Practitioner | 401 Roxbury Rd, Rockford, IL 61107-5075 | 2012-10-11 |
| 1710140041 | George Chahine Tannous | Internal Medicine | 401 Roxbury Rd, Rockford, IL 61107-5075 | 2008-07-07 |
| 1154597284 | Sumeet K. Tewani | Internal Medicine | 401 Roxbury Rd, Rockford, IL 61107-5075 | 2008-05-08 |
| 1588834519 | Ilche Teodore Nonevski | Internal Medicine | 401 Roxbury Rd, Rockford, IL 61107-5075 | 2008-03-05 |
| 1376751735 | Dawn M Vernon | Nurse Practitioner | 401 Roxbury Rd, Rockford, IL 61107-5075 | 2007-05-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| 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 |
|---|---|---|---|---|
| 1265052401 | Jet Healthcare LLC | Nurse Practitioner | 5979 Nebeshone Ln, Rockford, IL 61103-8926 | 2020-04-17 |
| 1760023162 | Mh Health Care Services, PC | Nurse Practitioner | 5943 E Riverside Blvd, Rockford, IL 61114-4935 | 2019-10-07 |
| 1235792045 | Michelle Anna Barrett | Nurse Practitioner | 6000 E State St Ste 1, Rockford, IL 61108-2521 | 2019-04-17 |
| 1780177030 | Emily Glass Mims | Nurse Practitioner | 9518 Us Highway 231, Rockford, AL 35132-5551 | 2018-06-12 |
| 1003269895 | Jason Roberts | Nurse Practitioner | 199 Longview Dr, Rockford, MI 49341-1130 | 2016-07-18 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1588800700 | Sylvia Ann Garza | Nurse Practitioner | 3401 N. Perryville Rd, Rockford Health Physicians, Rockford, IL 61114 | 2008-12-17 |
| 1295955284 | Jennifer Lee Binder | Nurse Practitioner | 2327 Nebraska Rd, Rockford, IL 61108-7510 | 2007-05-01 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1902995087 | Lori Ann Schultz | Nurse Practitioner | 1235 N Mulford Rd Ste 205, Rockford, IL 61107-3879 | 2006-10-12 |
| Find all providers in ROCKFORD | ||||
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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.