Stacy Maria Ford, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00179700 Issued in NJ

Practice address

175 Cross Keys Rd
Berlin, NJ 08009-9263

Phone

(856) 767-0077

Fax

(856) 767-0100

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stacy Ryker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EDAFBD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Neurology Associates PC

  • Neurology Physician
  • Cherry Hill, NJ
  • NPI 1205883782
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305504000000",
    "number": "1003026014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N KIRKWOOD AVE",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841163",
            "telephone_number": "856-261-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CROSS KEYS RD",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080099263",
            "telephone_number": "856-767-0077",
            "fax_number": "856-767-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "STACY",
        "middle_name": "MARIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00179700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "RYKER",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walter J Fennell, B.S.
• Jennifer Ferrari, LPC
• Michael B Fiore, BSPHARM,RPH
• Brianna A Fonte, M.S.
• Foot Health Centers, P.a.
• Marlee Frankel, PA
• Franklin Family Practice
• Fresh Start Healthcare
• Friends of Cyrus II Inc
• Valerie Gaither

• Physician Assistant in Berlin, NJ
• Providers in Berlin, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.