DR. TRACY KENDREW STEVENS (NPI# 1619948668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619948668 |
| Entity Type | Individual |
| Full Name | DR. TRACY KENDREW STEVENS |
| Credential | MD |
| Practice Address |
489 State St Bangor ME 04401-6616 |
| Mailing Address |
43 Whiting Hill Rd Brewer ME 04412-1005 |
| Practice Telephone | 2072751082 |
| Practice Fax Number | 2079735163 |
| Enumeration Date | 2006-01-29 |
| Last Update Date | 2018-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
MD21620 | ME | Allopathic & Osteopathic Physicians |
| N | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
042-0009661 | VT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760043673 | Tracy Lee Stevens | Nurse Practitioner | 2222 Ne 130th Ave, Portland, OR 97230-1705 | 2019-06-23 |
| 1417486663 | Tracy A Stevens | Registered Nurse | 1401 E State St Fl 2, Rockford, IL 61104-2315 | 2017-06-09 |
| 1033397252 | Tracy Stevens | Registered Nurse | 280 Seward Street, Rochester, NY 14608 | 2008-02-11 |
| 1679977037 | Tracy Nichole Stevens | Physical Therapist | 500 Lanier Ave W, Suite 303, Fayetteville, GA 30214-7636 | 2014-10-14 |
| 1992754154 | Tracy L Stevens | Internal Medicine | 4330 Wornall Rd, Suite 2000, Kansas City, MO 64111-5939 | 2006-05-08 |
| Street Address |
489 STATE ST |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-6616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790789147 | Eastern Maine Medical Center | General Acute Care Hospital | 489 State St, Bangor, ME 04401-6616 | 2005-06-13 |
| 1356956239 | Amanda Roberts | Physician Assistant | 489 State St, Bangor, ME 04401-6674 | 2020-09-09 |
| 1558983148 | Lana Caroline Hoertz | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2020-05-18 |
| 1427696954 | Kelsey A Mcgrath | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2019-12-16 |
| 1528629888 | Jaclyn Young | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2019-06-26 |
| 1568928018 | Emily Bohm | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-20 |
| 1144786971 | Andrew Hopkins | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-18 |
| 1750847083 | Daniel Patrick Conway | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-12 |
| 1306317847 | Matthew Daniel Kent | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2018-12-10 |
| 1750869061 | Brian Marsh | Nurse Practitioner | 489 State St, Bangor, ME 04401 | 2018-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255360582 | Mark S Brown | Pediatrics | Nicu Professional Services-emmc, 489 State Street, Bangor, ME 04401 | 2006-06-30 |
| 1245267335 | Ann Boomer | Pediatrics | Nicu Professional Services Emmc, 489 State Street, Bangor, ME 04401-0404 | 2006-06-26 |
| 1952412066 | David M Walter | Pediatrics | 489 State Street, Emmc -, Bangor, ME 04401-0404 | 2006-08-31 |
| 1447264494 | Mary Elizabeth Black | Pediatrics | 489 State St, Bangor, ME 04401-6616 | 2006-07-27 |
| 1740211283 | John Jay Hagerty | Pediatrics | 489 State St, Nicu Professional Services Emmc, Bangor, ME 04401-6616 | 2006-07-05 |
| 1821026055 | Macario F. Lichauco | Pediatrics | 489 State St, Kelly 6 Eastern Maine Medical Center, Bangor, ME 04401-6616 | 2006-06-28 |
| 1790761997 | Kumar Akilesh | Pediatrics | 489 State St, Bangor, ME 04401-6616 | 2005-12-20 |
| 1558345652 | Jay Kerecman | Pediatrics | 489 State St, Bangor, ME 04401-6616 | 2005-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780868778 | William Lee Salomon | Pediatrics | 79 Cobb Rd, Poland, ME 04274-6361 | 2007-12-26 |
| 1124148390 | Douglas Dransfield | Pediatrics | 22 Bramhall St, Portland, ME 04102-3134 | 2007-03-30 |
| 1124158522 | Michael Vozzelli | Pediatrics | 22 Bramhall St, Portland, ME 04102-3134 | 2007-03-06 |
| 1023148509 | Stephanie Boggs | Pediatrics | 300 Main St, Lewiston, ME 04240-7027 | 2007-03-06 |
| 1548390974 | Dale Kessler | Pediatrics | 22 Bramhall St, Portland, ME 04102-3134 | 2007-03-06 |
| 1053441410 | Daniel Sobel | Pediatrics | 22 Bramhall St, Portland, ME 04102-3134 | 2007-03-06 |
| 1275663775 | Peter Marro | Pediatrics | 22 Bramhall St, Portland, ME 04102-3134 | 2007-03-06 |
| 1831229277 | Brenda Medlin | Pediatrics | 22 Bramhall St, Portland, ME 04102-3134 | 2007-03-06 |
| 1417087883 | Maine Neonatology Associates | Pediatrics | 22 Bramhall St, Portland, ME 04102-3175 | 2007-03-06 |
Please comment or provide details below to improve the information on DR. TRACY KENDREW STEVENS.
| 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.