Active NPI
Gabrielle M. Stacy, PA-C
- Medical Physician Assistant
- Allentown, PA
National Provider Identifier
1811297823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- MA054708
- Practice address
- 1255 S Cedar Crest Blvd
Suite 2200
Allentown, PA 18103-6256 - Phone
- (610) 437-9006
- Fax
- (610) 437-1942
- NPI assigned
- Oct 25, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA054708 | PA | Primary |
Addresses
Primary practice location
1255 S Cedar Crest Blvd
Suite 2200
Allentown, PA 18103-6256
Mailing address
1255 S Cedar Crest Blvd
Suite 2200
Allentown, PA 18103-6256
Phone (610) 437-9006
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA054708 | PA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287964800000",
"number": "1811297823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1255 S CEDAR CREST BLVD",
"address_2": "SUITE 2200",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181036256",
"telephone_number": "610-437-9006",
"fax_number": "610-437-1942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 S CEDAR CREST BLVD",
"address_2": "SUITE 2200",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181036256",
"telephone_number": "610-437-9006",
"fax_number": "610-437-1942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACY",
"first_name": "GABRIELLE",
"middle_name": "M.",
"name_prefix": "Miss",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-25",
"last_updated": "2010-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA054708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.