Jade Monica-Marie Stacey, DEM TM

Primary specialty

Lay MidwifeTaxonomy code 175M00000X

Practice address

PO Box 576
Mandaree, ND 58757-0576

Phone

(406) 690-5694

Fax

(406) 303-4063

NPI assigned

Jun 21, 2024

Last updated

Jun 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1790529907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576",
            "city": "MANDAREE",
            "state": "ND",
            "postal_code": "587570576",
            "telephone_number": "406-690-5694",
            "fax_number": "406-303-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 576",
            "city": "MANDAREE",
            "state": "ND",
            "postal_code": "587570576",
            "telephone_number": "406-690-5694",
            "fax_number": "406-303-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "JADE",
        "middle_name": "MONICA-MARIE",
        "name_prefix": "Mrs.",
        "credential": "DEM TM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175M00000X",
            "taxonomy_group": "",
            "desc": "Midwife, Lay",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maximus Antonio Avila
• Madeline P Chase
• Kajanjan Constance Grady
• Mandaree Community Clinic
• Precision Paramedic Services Inc
• Three Affiliated Tribes Manadree Health Care Tele-Pharmacy (TAT Manadree Telepharmacy)
• Three Affiliated Tribes Mandaree Health Care Center (Mandaree Health Care Center)

• Lay Midwife in Mandaree, ND
• Providers in Mandaree, ND by specialty
• Lay Midwife in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.