Active NPI
Stacy Colwell
- Family Nurse Practitioner
- Kirkwood, NY
National Provider Identifier
1356876254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 341924
- Practice address
- 865 US Route 11
Kirkwood, NY 13795-1001 - Phone
- (607) 775-1771
- NPI assigned
- Apr 28, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 688990 | NY | |
| Family Nurse Practitioner | 363LF0000X | 341924 | NY | Primary |
Addresses
Primary practice location
865 US Route 11
Kirkwood, NY 13795-1001
Mailing address
33 Lewis Rd
2ND FL
Binghamton, NY 13905-1048
Phone (607) 729-8156
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 23, 2025 through Jul 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 688990 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498780800000",
"number": "1356876254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 LEWIS RD",
"address_2": "2ND FL",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139051048",
"telephone_number": "607-729-8156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "865 US ROUTE 11",
"city": "KIRKWOOD",
"state": "NY",
"postal_code": "137951001",
"telephone_number": "607-775-1771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLWELL",
"first_name": "STACY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-28",
"last_updated": "2017-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "688990",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "341924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.