STACY GORDON (NPI# 1821106758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821106758 |
| Entity Type | Individual |
| Full Name | STACY GORDON |
| Other Name | ANASTASIA GORDON |
| Credential | M.D. |
| Practice Address |
3401 Civic Center Blvd Children's Hospital of Philadelphia Philadelphia PA 19104-4319 |
| Mailing Address |
100 E Penn Sq 9th Floor North Tower Philadelphia PA 19107-3323 |
| Practice Telephone | 2155901944 |
| Practice Fax Number | 2155904454 |
| Mailing Telephone | 2674259234 |
| Mailing Fax Number | 2674259299 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2014-04-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | MD071070L | PA | Allopathic & Osteopathic Physicians |
| Y | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
MD071070L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 001803790 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740821792 | Stacy Lynn Gordon | Behavior Technician | 2981 Kanell Blvd, Poplar Bluff, MO 63901-4008 | 2019-10-01 |
| 1477902351 | Stacy Gordon | Counselor | 602 N Walton Blvd, Bentonville, AR 72712-4576 | 2016-06-10 |
| 1568839785 | Stacy Frances Gordon | Social Worker | 36 Edgar Ave, Brookhaven, NY 11719-9655 | 2015-08-24 |
| Street Address |
3401 CIVIC CENTER BLVD CHILDREN'S HOSPITAL OF PHILADELPHIA |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467458463 | Jeffrey R Boris | Pediatrics | 3401 Civic Center Blvd, Children's Hospital of Philadelphia - Cardiology, Philadelphia, PA 19104-4319 | 2005-06-23 |
| 1932700259 | Rukhsar Karim Machiwalla | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-11-03 |
| 1346840519 | Vanessa Leigh Jones | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-27 |
| 1275131849 | Kelsey Ann Maher | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-15 |
| 1437756020 | Jennifer-rose Eccles | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-06 |
| 1891309787 | Morgan Mcmanus | Genetic Counselor, MS | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-09-08 |
| 1891309456 | Abigail G Stefanides | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-09-01 |
| 1124631247 | Abrar Khaled Alabdulhadi | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-28 |
| 1003427014 | Terrence Caldwell Jr. | Pharmacist | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-13 |
| 1760093298 | Paige Emily Naschke | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 2080P0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Emergency Medicine |
| A pediatrician who has special qualifications to manage emergencies in infants and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639640600 | Children's Hospital of Philadelphia | Pediatrics | 3401 Civic Center Blvd Rm 7471, Philadelphia, PA 19104-4319 | 2018-12-17 |
| 1093340424 | Nusheen Goshtasbi | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-03-05 |
| 1144864547 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-30 |
| 1578024618 | Lauren Elisabeth Wooley | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-03-30 |
| 1841644689 | Kaleena Patel | Pediatrics | 3401 Civic Center Blvd, Division of Pediatric Emergency Medicine, Philadelphia, PA 19104 | 2016-04-18 |
| 1720440597 | Hanae Fujii Rios | Pediatrics | 3401 Civic Center Blvd, Division of Pediatric Emergency Medicine, Philadelphia, PA 19104 | 2016-03-22 |
| 1912391582 | Lillian Buchhalter | Pediatrics | 3401 Civic Center Blvd, Division of Emergency Medicine, Philadelphia, PA 19104 | 2015-03-23 |
| 1336553288 | Jasmine Taylor Umana | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104 | 2014-06-19 |
| 1932452463 | Mindy Fein | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2012-10-22 |
| 1487910337 | Danielle Cullen | Pediatrics | 3401 Civic Center Blvd, Division of Pediatric Emergency Medicine, Philadelphia, PA 19104 | 2012-04-04 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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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.