Carrie Jean Gordon-Stacey, CNM

Primary specialty

MidwifeTaxonomy code 176B00000X

License

001506 Issued in NY

Practice address

2231 Burdett Ave Ste 160
Troy, NY 12180-2453

Phone

(518) 326-1620

NPI assigned

Feb 14, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cgordonstacey1372413@direct.trinity-health.org

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.

• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727
  NPD
• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1538606181
  NPD
• St. Peter'S Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834
  NPD
• Whitney M. Young Jr. Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albany, NY
  • NPI 1942660105
  NPD (past)

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1588904320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 BURDETT AVE STE 160",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802453",
            "telephone_number": "518-326-1620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "713 Troy Schenectady Rd Ste 304",
            "address_purpose": "LOCATION",
            "city": "Latham",
            "state": "NY",
            "postal_code": "121102490",
            "country_code": "US",
            "telephone_number": "518-786-6270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 Route 146 Ste 150",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120653874",
            "country_code": "US",
            "telephone_number": "518-373-4555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Empire Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Rensselaer",
            "state": "NY",
            "postal_code": "121445730",
            "country_code": "US",
            "telephone_number": "518-373-4555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2231 Burdett Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802447",
            "country_code": "US",
            "telephone_number": "518-271-3900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31 Lower Hudson Ave",
            "address_purpose": "LOCATION",
            "city": "Green Island",
            "state": "NY",
            "postal_code": "121831014",
            "country_code": "US",
            "telephone_number": "518-272-9140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 River St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Valatie",
            "state": "NY",
            "postal_code": "121849696",
            "country_code": "US",
            "telephone_number": "518-938-1980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 Burdett Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-271-3900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "706 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083604",
            "country_code": "US",
            "telephone_number": "518-466-0209",
            "fax_number": "518-813-9291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON-STACEY",
        "first_name": "CARRIE",
        "middle_name": "JEAN",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-14",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "FOO1506-1",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "001506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2231 Burdett Ave Ste 160",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121802453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shana R Goldman, LMSW
• Jason Goldstein
• Leslie S Goldstein, M.D.
• Golub Corporation
• Erin Elizabeth Goodale, RN
• Nicholas Ryan Gordon, PHARMD,RPH
• Meg Gorman, MSED
• Bryanna Gourrier
• Tyler Graber
• Alexi Graham

• Midwife in Troy, NY
• Providers in Troy, NY by specialty
• Midwife in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.