STACIE RENEE GREGORY


Address: 301 N 8th St, Pav 5b, Springfield, IL 62701-1041
Phone: 2175458000

STACIE RENEE GREGORY (NPI# 1336436435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336436435
Entity Type Individual
Full Name STACIE RENEE GREGORY
Credential M.D.
Practice Address 301 N 8th St
Pav 5b
Springfield
IL 62701-1041
Mailing Address 301 N 8th St
Po Box 19662
Springfield
IL 62701-1041
Practice Telephone 2175458000
Practice Fax Number 2175450253
Mailing Telephone 2175458000
Mailing Fax Number 2175450253
Enumeration Date 2011-07-09
Last Update Date 2020-10-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Y00000X Otolaryngology 036-142803 IL Allopathic & Osteopathic Physicians
N 207YP0228X Otolaryngology
Specialization: Pediatric Otolaryngology
036-142803 IL Allopathic & Osteopathic Physicians

Office Location

Street Address 301 N 8TH ST
PAV 5B
City SPRINGFIELD
State IL
Zip Code 62701-1041

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578565420 Samuel Poriza Au Radiology 301 N 8th St, Springfield, IL 62701-1041 2005-08-11
1073148375 Ashley Kirkpatrick Nurse Practitioner 301 N 8th St, Springfield, IL 62701-1041 2020-03-06
1699260299 Eman Mosleh Pediatrics 301 N 8th St, Springfield, IL 62701-1041 2018-06-26
1508370719 Linsey Meloche Nurse Practitioner 301 N 8th St, Springfield, IL 62701-1041 2017-11-27
1649789736 Nichole Kristine Chatham Occupational Therapist 301 N 8th St, Springfield, IL 62701-1041 2017-09-21
1174075147 Loralee Donnelly Nurse Practitioner 301 N 8th St, Springfield, IL 62701 2016-10-26
1740639533 Matthew Leland Davis Urology 301 N 8th St, Springfield, IL 62701-1041 2016-06-13
1578910741 Bradley Christopher Holland Urology 301 N 8th St, 4b143c, Springfield, IL 62701-1041 2016-05-18
1295182467 Meredith Volle Pediatrics 301 N 8th St, 4a, Springfield, IL 62701-1041 2016-05-18
1205299542 Rebecca S. Vanmeter Nurse Practitioner 301 N 8th St, Springfield, IL 62701-1041 2016-04-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932687183 Affinity Patient Coordination LLC In Home Supportive Care 217 E Monroe St Ste 102, Springfield, IL 62701 2018-07-31
1427498435 Donald L Jacoby Pharmacist 701 N. First St., Springfield, IL 62701 2013-07-05
1700183480 Erin Zepp Dietitian, Registered 319 E Madison St Ste 1f, Springfield, IL 62701 2011-02-16
1518117159 Jyoti Assudani Pediatrics 301 N 8th Street, Springfield, IL 62701 2008-09-19
1396924148 Jeanne Lyn Malone Counselor 408 South Fifth Street, Springfield, IL 62701 2007-10-29
1942422928 Nobuharu Harada Family Medicine 301 N 8th, Pav-3a158, Springfield, IL 62701 2007-05-02
1427131127 Radiological Associates of Decatur Radiology 319 E Madison Suite J, Springfield Mri & Imaging Center, Springfield, IL 62701 2006-10-24
1669498606 Independence Holding Co LLC Pharmacy 201 North 5th Street, Springfield, IL 62701 2006-07-14
1720070238 Neil J. Thomas Thoracic Surgery (Cardiothoracic Vascular Surgery) 619 E Mason St Ste 4p57, Springfield, IL 62701 2005-08-19
1588187397 Andrea Nicole Bloodworth Internal Medicine 619 E Mason St Ste 4p57, Springfield, IL 62701 2017-07-24
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Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104354414 Sara M. Wing Otolaryngology 301 N 8th St Ste 5b, Springfield, IL 62701-1041 2017-05-31
1194157511 Harvey Thomas Staton Otolaryngology 3115 Henderson Ct, Springfield, OH 45503-1307 2013-08-08
1114052784 Robert H Osofsky Md PC Otolaryngology 299 Carew St., Suite 330, Springfield, MA 01104 2007-02-22
1760552897 Doctors Hearing Center LLC Xiv Otolaryngology 628 Commercial Street, Springfield, MO 75803 2006-11-08
1598875676 Eric Furst Otolaryngology 5504 Backlick Rd, Springfield, VA 22151 2006-08-30
1831113919 Michelle M Roeser Otolaryngology 8314 Traford Ln, C, Springfield, VA 22152-1651 2006-07-26
1952347254 Carl E Reiner Otolaryngology 100 E Wason Avenue, Suite 100, Springfield, MA 01107 2006-06-22
1316910714 Springfield Hospital Otolaryngology 364 River St, Springfield, VT 05156 2006-02-08
1851362289 Michael B Duvall Otolaryngology 435 South Burnett Road, Springfield, OH 45505-2717 2006-02-01
1053382689 Ear, Nose and Throat of Springfield, Inc Otolaryngology 435 S Burnett Rd, Springfield, OH 45505-2717 2006-01-31
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Competitor

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City SPRINGFIELD
Zip Code 62701

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Dataset Information

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.

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