Active NPI
Stacy Nawrocki
- Speech-Language Pathologist
- Erie, PA
National Provider Identifier
1003480310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 41 W Gore Rd
Erie, PA 16509-3621 - Phone
- (814) 864-4867
- Fax
- (317) 449-5783
- NPI assigned
- May 20, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
41 W Gore Rd
Erie, PA 16509-3621
Mailing address
3916 David Rd
Erie, PA 16510-6318
Phone (814) 464-4859
Other names 1
- Stacy Wigfield
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL007972 | PA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621468800000",
"number": "1003480310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3916 DAVID RD",
"city": "ERIE",
"state": "PA",
"postal_code": "165106318",
"telephone_number": "814-464-4859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 W GORE RD",
"city": "ERIE",
"state": "PA",
"postal_code": "165093621",
"telephone_number": "814-864-4867",
"fax_number": "317-449-5783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAWROCKI",
"first_name": "STACY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-20",
"last_updated": "2021-05-20",
"certification_date": "2021-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "STACY",
"last_name": "WIGFIELD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.